Provider Demographics
NPI:1780439315
Name:CORNERSTONE MEDICAL PC
Entity type:Organization
Organization Name:CORNERSTONE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-962-5207
Mailing Address - Street 1:265 SUNRISE HWY STE 1-815
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CTR
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4912
Mailing Address - Country:US
Mailing Address - Phone:516-536-2300
Mailing Address - Fax:
Practice Address - Street 1:2914 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2141
Practice Address - Country:US
Practice Address - Phone:516-536-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY290581OtherLICENSE