1609991694 NPI number — DR YUSUF'S GETWELL PEDIATRICS OF NEW YORK, PLLC

Table of content: (NPI 1609991694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609991694 NPI number — DR YUSUF'S GETWELL PEDIATRICS OF NEW YORK, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR YUSUF'S GETWELL PEDIATRICS OF NEW YORK, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609991694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5707 146TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11355-5322
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5707 146TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-5322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-461-8625
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YUSUF
Authorized Official First Name:
FAZLUL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-255-2333

Provider Taxonomy Codes

  • Taxonomy code: 2080P0207X , with the licence number:  191806 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 041018000054 . This is a "FIDELIS (FLUSHING)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QN0023504 . This is a "AMERICHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133813294YU02 . This is a "CARE PLUS (WOODSIDE)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DP537 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000026774 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 100116075802 . This is a "UHC (HMO)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 100477 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 191806 . This is a "METROPLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 26P3231 . This is a "NY PRESBYTERIAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 26P3233 . This is a "NY PRESBYTERIAN -WOODSIDE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3430579 . This is a "AETNA (HEMATOLOGY)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 536Z11 . This is a "EMPIRE BCBS (FLUSHING)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113381329YU01 . This is a "CARE PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 26N8431 . This is a "NEIGHBORHOOD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 536Z12 . This is a "EMPIRE BCBS (WOODSIDE)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 543894 . This is a "AETNA (HMO)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 041018000056 . This is a "FIDELIS (WOODSIDE)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2695502 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7399614 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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