Basic Information
| Provider Information | |||||||||
| NPI: | 1154552008 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YOUSUF | ||||||||
| FirstName: | HUMERA | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CNIM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1086 TEANECK RD | ||||||||
| Address2: | SUITE 4A | ||||||||
| City: | TEANECK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076664854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018629900 | ||||||||
| FaxNumber: | 2018629136 | ||||||||
| Practice Location | |||||||||
| Address1: | 1086 TEANECK RD | ||||||||
| Address2: | SUITE 4A | ||||||||
| City: | TEANECK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076664854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018629900 | ||||||||
| FaxNumber: | 2018629136 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2009 | ||||||||
| LastUpdateDate: | 04/23/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZE0600X | 1781 | NJ | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic |
No ID Information.