=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013274927
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. SYEDA RABIA YOUNUS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2012
-----------------------------------------------------
Last Update Date | 06/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 W WILLIAMS ST SUITE 251
-----------------------------------------------------
City | APEX
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27502-5203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-303-0273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 W WILLIAMS ST SUITE 251
-----------------------------------------------------
City | APEX
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27502-5203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 201502-148
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------