Healthcare Provider Details

I. General information

NPI: 1598714784
Provider Name (Legal Business Name): YOUSEF ZIBDIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 MCBRIDE AVE
WEST PATERSON NJ
07424-2745
US

IV. Provider business mailing address

871 MCBRIDE AVE
WOODLAND PARK NJ
07424-2748
US

V. Phone/Fax

Practice location:
  • Phone: 973-569-4488
  • Fax: 973-569-4743
Mailing address:
  • Phone: 973-569-4488
  • Fax: 973-569-4743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA062346
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: