MEDICARE: SHEIKH M. YOUSUF-ALI MD

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	016566	CT
2	207RC0000X	Cardiovascular Disease Physician	016566	CT

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	:	1396800868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEIKH M. YOUSUF-ALI MD

Provider Business Mailing Address
First Line	:	515 NORTH RIDGEFIELD AVE
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-2557
Country	:	US
Telephone Number	:	203-334-7654
Fax Number	:	203-334-2501

Provider Business Practice Location Address
First Line	:	515 NORTH RIDGEFIELD AVE
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-2557
Country	:	US
Telephone Number	:	203-334-7654
Fax Number	:	203-334-2501

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	03/27/2012

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