Provider Demographics
NPI:1336794619
Name:AFIFI, YUSUF RICHARD (PA-C)
Entity type:Individual
Prefix:
First Name:YUSUF
Middle Name:RICHARD
Last Name:AFIFI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:Y. RICHARD
Other - Middle Name:
Other - Last Name:AFIFI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1303 EAGLES RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1141
Mailing Address - Country:US
Mailing Address - Phone:914-227-0506
Mailing Address - Fax:
Practice Address - Street 1:45 READE PL
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3947
Practice Address - Country:US
Practice Address - Phone:845-454-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024751363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant