MEDICARE: DR. DANIEL STEVEN YOUSEFZADEH DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	4OQA01383200	NJ
2	225100000X	Physical Therapist	4OQA01383200	NJ

General Provider Information

NPI Number	:	1811297153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL STEVEN YOUSEFZADEH DPT

Provider Business Mailing Address
First Line	:	1539 ROCKAWAY RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3931
Country	:	US
Telephone Number	:	917-704-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	1539 ROCKAWAY RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3931
Country	:	US
Telephone Number	:	917-704-2367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2010
Last Update Date	:	12/30/2018

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