Provider Demographics
NPI:1558917591
Name:YUSUF, HELENICA (NUTRITIONIST MS, CDN)
Entity Type:Individual
Prefix:MRS
First Name:HELENICA
Middle Name:
Last Name:YUSUF
Suffix:
Gender:F
Credentials:NUTRITIONIST MS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROOKDALE PLAZA 2ACC- Q RM 229-E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3198
Mailing Address - Country:US
Mailing Address - Phone:710-240-5022
Mailing Address - Fax:718-240-7396
Practice Address - Street 1:1 BROOKDALE PLAZA 2ACC- Q RM 229-E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3198
Practice Address - Country:US
Practice Address - Phone:718-240-5022
Practice Address - Fax:718-240-7396
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004330133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty