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Provider Information for 1588703052

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. YOUSEF MOUSSA DDS

Other Name:   JOSEPH MOUSSA
Gender: MALE

Individual NPI: 1588703052

Calendar   Last Updated:  2010-07-16
  Certification Date: 

Details

Name Value
NPI 1588703052
Enumeration Date 2007-02-05
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1018 BROAD ST
BLOOMFIELD, NJ 07003-2884
United States

Phone: 973-338-9191 | Fax:
View Map External Link
Primary Practice Address 1018 BROAD ST
BLOOMFIELD, NJ 07003-2884
United States

Phone: 973-338-9191 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 02413445
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NJ 22948
No 1223G0001X - Dentist General Practice NY 050740-1