Provider Demographics
NPI:1962055178
Name:YUSUFZAI, DANIAL (OD)
Entity type:Individual
Prefix:DR
First Name:DANIAL
Middle Name:
Last Name:YUSUFZAI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 1ST AVE SW APT 212
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-3374
Mailing Address - Country:US
Mailing Address - Phone:416-560-2916
Mailing Address - Fax:
Practice Address - Street 1:3462 55TH ST NW STE 600
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0203
Practice Address - Country:US
Practice Address - Phone:507-206-5047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3645152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist