MEDICARE: YURI MAZUR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MA07878500	NJ

General Provider Information

NPI Number	:	1255380879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YURI MAZUR MD

Provider Business Mailing Address
First Line	:	17 MOLSBURY LN
Second Line	:
City	:	MILLSTONE TOWNSHIP
State	:	NJ
Zip	:	08510-8763
Country	:	US
Telephone Number	:	732-491-5314
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 MOLSBURY LN
Second Line	:
City	:	MILLSTONE TOWNSHIP
State	:	NJ
Zip	:	08510-8763
Country	:	US
Telephone Number	:	732-491-5314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	03/07/2023

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