Healthcare Provider Details
I. General information
NPI: 1336739903
Provider Name (Legal Business Name): KYLE JOSEPH YURO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/19/2021
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8116 RITCHIE HWY
PASADENA MD
21122-6916
US
IV. Provider business mailing address
2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US
V. Phone/Fax
- Phone: 443-261-2220
- Fax: 410-544-5376
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 40QA01987800 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | DE |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 29923 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: