MEDICARE: ALI YOUSSEF

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	183500000X	Pharmacist	28RI04346600	NJ

General Provider Information

NPI Number	:	1144090929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI YOUSSEF

Provider Business Mailing Address
First Line	:	4592 S BROAD ST
Second Line	:
City	:	TRENTON
State	:	NJ
Zip	:	08620-2204
Country	:	US
Telephone Number	:	609-963-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	NORTH COOPERSTOWN PLAZA, 4362 US-130 NORTH
Second Line	:
City	:	WILLINGBORO
State	:	NJ
Zip	:	08046
Country	:	US
Telephone Number	:	609-386-9411
Fax Number	:

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

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	01/03/2024

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Directions to “ ALI YOUSSEF ” Practice Location

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