MEDICARE: SHEHLA YUSAF M.D.

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
1	2084P0800X	Psychiatry Physician	4301084713	MI
2	2084P0800X	Psychiatry Physician	229861	NY

General Provider Information

NPI Number	:	1497943815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEHLA YUSAF M.D.

Provider Business Mailing Address
First Line	:	385 OAK ST
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-6543
Country	:	US
Telephone Number	:	516-705-3400
Fax Number	:	516-705-3418

Provider Business Practice Location Address
First Line	:	385 OAK ST
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-6543
Country	:	US
Telephone Number	:	516-705-3400
Fax Number	:	516-705-3418

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	01/20/2011

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