Provider Demographics
NPI:1801452479
Name:YUSUF, YUSUF
Entity type:Individual
Prefix:
First Name:YUSUF
Middle Name:
Last Name:YUSUF
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 1:132 MARGINAL WAY APT 224C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2485
Mailing Address - Country:US
Mailing Address - Phone:207-415-3438
Mailing Address - Fax:
Practice Address - Street 1:132 MARGINAL WAY APT 224C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2485
Practice Address - Country:US
Practice Address - Phone:207-415-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-19
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide