Individual
DR. MENA YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1347
(516) 562-6000
Mailing address
PO BOX 192, PORT WASHINGTON, NY 11050-0192
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
25MB00926100
NJ
208M00000X
Hospitalist Physician
306224
NY
390200000X
Student in an Organized Health Care Education/Training Program
640750326
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/14/2014
Last updated
11/03/2023
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