Healthcare Provider Details

I. General information

NPI: 1689679029
Provider Name (Legal Business Name): JOSEPH YARZE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 IRONGATE CTR
GLENS FALLS NY
12801-3471
US

IV. Provider business mailing address

5 IRONGATE CTR
GLENS FALLS NY
12801-3471
US

V. Phone/Fax

Practice location:
  • Phone: 518-793-5034
  • Fax:
Mailing address:
  • Phone: 518-793-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number191009
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: