Basic Information
| Provider Information | |||||||||
| NPI: | 1689607434 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YEROUSHALMI | ||||||||
| FirstName: | MASOOD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 375 STOCKHOLM STREET | ||||||||
| Address2: | C/O FACULTY PRACTICE | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189606551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 375 STOCKHOLM STREET | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189606551 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 09/06/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 225569 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.