Provider Demographics
NPI:1447231568
Name:YOUSIF, NEDA N (MD)
Entity type:Individual
Prefix:DR
First Name:NEDA
Middle Name:N
Last Name:YOUSIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:781-465-6350
Mailing Address - Fax:781-485-6391
Practice Address - Street 1:300 OCEAN AVENUE RVR
Practice Address - Street 2:REVERE HEALTHCARE CENTER
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3675
Practice Address - Country:US
Practice Address - Phone:781-485-6350
Practice Address - Fax:781-485-6391
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA225535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA462223OtherTUFTS HEALTH PLAN
MAJ28853OtherBCBS MA
MAA38887Medicare ID - Type Unspecified
MAJ28853OtherBCBS MA