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Individual

MAKEEN KHALIL YACOUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MDFRCS

Contact information

Practice address
9 GRAND STREET, WARWICK, NY 10990
(845) 986-5121
(845) 988-5131
Mailing address
9 GRAND STREET, PO BOX 934, WARWICK, NY 10990
(845) 986-5121
(845) 988-5131

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
152366
NY
208600000X
Surgery Physician
152366
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0034259
GHI
NY
05
01055590
NY
01
1000015413
AFFINITY
NY
01
10576
AMERIGROUP
NJ
01
14867
HUDSON HEALTH
NY
01
3010366
AETNA HMO
NY
01
37414
AETNA
NJ
01
4531177
CIGNA
NJ
01
4531177
AETNA
NY
01
4C1598
HEALTH NET
NY
01
5358892
CIGNA
NY
01
5358892010
CIGNA HMO
NY
01
738828
UNITED HEALTHCARE
NY
01
F04747
HEALTH NET
NJ
01
P44374095
MULTIPEAN
NY
01
P462464
OXFORD
NY
01
PIRS27858P
HIP
NY
Enumeration date
07/19/2006
Last updated
09/11/2025
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