Provider Demographics
NPI:1053129858
Name:YUSUF, MARYAN AHMED
Entity type:Individual
Prefix:
First Name:MARYAN
Middle Name:AHMED
Last Name:YUSUF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 WASHINGTON ST NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-5666
Mailing Address - Country:US
Mailing Address - Phone:612-245-1855
Mailing Address - Fax:
Practice Address - Street 1:5700 WASHINGTON ST NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-5666
Practice Address - Country:US
Practice Address - Phone:612-245-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-25
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care