1932990991 NPI number — DR. YASIR FOUAD MAKI MOHAMMED TAKI M.D.

Table of content: DR. YASIR FOUAD MAKI MOHAMMED TAKI M.D. (NPI 1932990991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932990991 NPI number — DR. YASIR FOUAD MAKI MOHAMMED TAKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAKI
Provider First Name:
YASIR
Provider Middle Name:
FOUAD MAKI MOHAMMED
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1932990991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
475 SEAVIEW AVENUE, INTERNAL MEDICINE RESIDENCY
Provider Second Line Business Mailing Address:
ATTN: MARINELA LUKAJ
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-226-8313
Provider Business Mailing Address Fax Number:
718-226-9516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
475 SEAVIEW AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-226-8313
Provider Business Practice Location Address Fax Number:
718-226-9516
Provider Enumeration Date:
05/16/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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