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General NPI Number Information
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NPI Number | 1578645016
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Entity Type | Organization
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Legal Business Name | YURI USHER PT PC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 114 HARDS LN
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City | LAWRENCE
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State | NY
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Zip | 11559-1315
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Country | US
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Telephone | 516-650-5756
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Fax | 516-239-1903
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Provider Business Mailing Address
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Address Line | 114 HARDS LN
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City | LAWRENCE
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State | NY
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Zip | 11559-1315
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Country | US
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Telephone | 516-650-5756
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Fax | 516-239-1903
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. YURI USHER
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Credential | P.T.
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Telephone | 516-650-5756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 013636
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License Number State | NY
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