Healthcare Provider Details
I. General information
NPI: 1023729043
Provider Name (Legal Business Name): SAVELY YURKOVSKY PHYSICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2022
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 KISCO AVE STE X
MOUNT KISCO NY
10549-1414
US
IV. Provider business mailing address
120 KISCO AVE STE X
MOUNT KISCO NY
10549-1414
US
V. Phone/Fax
- Phone: 914-861-9161
- Fax:
- Phone: 914-861-9161
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SAVELY
YURKOVSKY
Title or Position: OWNER
Credential: MD
Phone: 914-861-9161