Healthcare Provider Details

I. General information

NPI: 1487759171
Provider Name (Legal Business Name): DAVID YORIO D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 03/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HAMBURG TPKE STE 18B
WAYNE NJ
07470-2132
US

IV. Provider business mailing address

220 HAMBURG TPKE STE 18B
WAYNE NJ
07470-2132
US

V. Phone/Fax

Practice location:
  • Phone: 973-826-0068
  • Fax:
Mailing address:
  • Phone: 973-826-0068
  • Fax: 973-807-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number25MB07947800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: