Provider Demographics
NPI:1760213565
Name:AZEEZ, YUSUF A (MS, RD)
Entity type:Individual
Prefix:MR
First Name:YUSUF
Middle Name:A
Last Name:AZEEZ
Suffix:
Gender:M
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ANGELA LN APT 7
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1503
Mailing Address - Country:US
Mailing Address - Phone:202-971-0269
Mailing Address - Fax:
Practice Address - Street 1:26 ANGELA LN APT 7
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-1503
Practice Address - Country:US
Practice Address - Phone:202-971-0269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86459364133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered