Provider Demographics
NPI:1588012843
Name:YUSUFA, MARIJOH I
Entity Type:Individual
Prefix:
First Name:MARIJOH
Middle Name:
Last Name:YUSUFA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9893 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:240-615-1050
Mailing Address - Fax:
Practice Address - Street 1:9893 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3220
Practice Address - Country:US
Practice Address - Phone:240-615-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide