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NPI Code Detail

MEDICARE: ALL BOROUGH PHYSICIAN SERVICES MEDICAL PC

MEDICARE: ALL BOROUGH PHYSICIAN SERVICES MEDICAL PC
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
1207LP2900XPain Medicine (Anesthesiology) Physician198461NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619138419
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALL BOROUGH PHYSICIAN SERVICES MEDICAL PC
Provider Business Mailing Address
First Line : 31 PROSPECT AVE
Second Line :
City : LARCHMONT
State : NY
Zip : 10538-4151
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 HIGH ST
Second Line :
City : PORT CHESTER
State : NY
Zip : 10573-4402
Country : US
Telephone Number : 914-772-2244
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. IGOR YUKELIS
Credential : M.D.
Telephone Number : 914-772-2244
Provider Enumeration Date : 06/24/2008
Last Update Date : 11/14/2016

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Directions to “ALL BOROUGH PHYSICIAN SERVICES MEDICAL PC ” Practice Location

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