Healthcare Provider Details

I. General information

NPI: 1073993671
Provider Name (Legal Business Name): AYMAN YOUSEF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28511 DUPONT BLVD
MILLSBORO DE
19966-4787
US

IV. Provider business mailing address

28511 DUPONT BLVD
MILLSBORO DE
19966-4787
US

V. Phone/Fax

Practice location:
  • Phone: 302-934-8175
  • Fax:
Mailing address:
  • Phone: 302-934-8175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0004735
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: