Healthcare Provider Details

I. General information

NPI: 1588608392
Provider Name (Legal Business Name): LYNN M YURKOFSKY DPM, PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 BALDWIN MILL RD
JARRETTSVILLE MD
21084-1929
US

IV. Provider business mailing address

2004 WAGNER FARM RD
BEL AIR MD
21015-2048
US

V. Phone/Fax

Practice location:
  • Phone: 410-692-5591
  • Fax: 410-692-5518
Mailing address:
  • Phone: 410-638-2204
  • Fax: 410-638-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01275
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: