Healthcare Provider Details

I. General information

NPI: 1679319073
Provider Name (Legal Business Name): YUHAS NUTRITION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 07/04/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6846 BUCKLEY RD
NORTH SYRACUSE NY
13212-4275
US

IV. Provider business mailing address

111 CRAIG CIR
SYRACUSE NY
13214-1825
US

V. Phone/Fax

Practice location:
  • Phone: 315-410-6400
  • Fax: 315-410-6410
Mailing address:
  • Phone: 814-270-1752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN M YUHAS
Title or Position: OWNER
Credential: MS, RDN, CND
Phone: 814-270-1752