Provider Demographics
NPI:1912481946
Name:DR EMAD YOUSSEF PODIATRY LLC
Entity Type:Organization
Organization Name:DR EMAD YOUSSEF PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:G
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-897-2488
Mailing Address - Street 1:14 W 11TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2508
Mailing Address - Country:US
Mailing Address - Phone:201-897-2488
Mailing Address - Fax:201-603-6639
Practice Address - Street 1:14 W 11TH ST FL 1
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2508
Practice Address - Country:US
Practice Address - Phone:201-897-2488
Practice Address - Fax:201-603-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty