Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 191806 | NY |
NPI | 1295802965 |
---|---|
Provider Name | Dr. Fazlul Hamid Yusuf |
First Address | Flushing, NY 11355-5322 |
Second Address | Flushing, NY 11355-5322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014978896 | (05) | NY |
F68087 | (02) | NY |