Healthcare Provider Details

I. General information

NPI: 1518617083
Provider Name (Legal Business Name): NICOLE TURTURRO-YURICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 EASTCHESTER RD
BRONX NY
10461-2604
US

IV. Provider business mailing address

1621 EASTCHESTER RD
BRONX NY
10461-2604
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8040
  • Fax:
Mailing address:
  • Phone: 718-405-8040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number343938
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number343938
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: