Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 199752-1 | NY |
NPI | 1053474866 |
---|---|
Provider Name | Maged Z Youssef-Ahmed |
First Address | Rockville Centre, NY 11570 |
Second Address | Forest Hills, NY 11375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 24/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01625007 | (05) | NY |
G21538 | (02) | NY |