MEDICARE: DR. MOHAMMED YOUSUFUDDIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	216171	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033137351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED YOUSUFUDDIN M.D.

Provider Business Mailing Address
First Line	:	2140 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2546
Country	:	US
Telephone Number	:	718-692-4334
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 FOSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1607
Country	:	US
Telephone Number	:	718-421-1756
Fax Number	:	718-421-2497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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