Healthcare Provider Details

I. General information

NPI: 1346402914
Provider Name (Legal Business Name): YASIR EL-SHERIF M.D., PHD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SEAVIEW AVE NEW YORK EPILEPSY & NEUROLOGY
STATEN ISLAND NY
10305-3419
US

IV. Provider business mailing address

501 SEAVIEW AVE NEW YORK EPILEPSY & NEUROLOGY
STATEN ISLAND NY
10305-3419
US

V. Phone/Fax

Practice location:
  • Phone: 718-683-3766
  • Fax:
Mailing address:
  • Phone: 718-683-3766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number257409
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: