Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 25MA06664700 | NJ |
NPI | 1801826219 |
---|---|
Provider Name | Dr. Oliver Samir Youssef |
First Address | Nutley, NJ 07110-2924 |
Second Address | Clifton, NJ 07013-2724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 18/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0037133 | (05) | NJ |
H13241 | (02) | NJ |