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NPI Code Detail

MEDICARE: DR. IYAD YOUSEF MOHAMMAD IDRIES

MEDICARE: DR. IYAD YOUSEF MOHAMMAD IDRIES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician340933-1NY

General Provider Information

NPI Number : 1215656053
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IYAD YOUSEF MOHAMMAD IDRIES
Provider Business Mailing Address
First Line : 1 BROOKDALE PLZ
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-3139
Country : US
Telephone Number : 718-240-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1 BROOKDALE PLZ
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-3139
Country : US
Telephone Number : 347-715-8901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2022
Last Update Date : 01/21/2026

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