Provider Demographics
NPI:1508614074
Name:YOUSIF, FAISAL S
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:S
Last Name:YOUSIF
Suffix:
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 1:1344 SCHOONER WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9293
Mailing Address - Country:US
Mailing Address - Phone:651-493-9260
Mailing Address - Fax:651-493-9269
Practice Address - Street 1:1344 SCHOONER WAY
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9293
Practice Address - Country:US
Practice Address - Phone:651-493-9260
Practice Address - Fax:651-493-9269
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide