Healthcare Provider Details

I. General information

NPI: 1295990067
Provider Name (Legal Business Name): MOBEEN YOUSAF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PROSPECT AVE.
SYRACUSE NY
13203
US

IV. Provider business mailing address

17 THOMAS GRV
PITTSFORD NY
14534-3069
US

V. Phone/Fax

Practice location:
  • Phone: 315-299-5451
  • Fax: 855-851-4405
Mailing address:
  • Phone: 585-754-3211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number263554
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number263554-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: