MEDICARE: DR. MOHAMED H YOSRY 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	2084P0800X	Psychiatry Physician	25MA05578000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25MA05578000	OTHER	NJ	STATE LICENSE

General Provider Information

NPI Number	:	1932170651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMED H YOSRY M.D.

Provider Business Mailing Address
First Line	:	40 BEY LEA RD
Second Line	:	SUITE B 201
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2900
Country	:	US
Telephone Number	:	732-240-5544
Fax Number	:	732-240-1180

Provider Business Practice Location Address
First Line	:	40 BEY LEA RD
Second Line	:	SUITE B 201
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2900
Country	:	US
Telephone Number	:	732-240-5544
Fax Number	:	732-240-1180

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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