Healthcare Provider Details

I. General information

NPI: 1265594402
Provider Name (Legal Business Name): JOHN M YAVORSKY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 CENTER STREET
GARWOOD NJ
07027-1231
US

IV. Provider business mailing address

328 W SAINT GEORGES AVE
LINDEN NJ
07036-5638
US

V. Phone/Fax

Practice location:
  • Phone: 908-789-0626
  • Fax: 908-789-3123
Mailing address:
  • Phone: 908-925-7519
  • Fax: 908-925-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB05872500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: