MEDICARE: DR. JUSTIN MARK YOZAWITZ M.D.

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	208600000X	Surgery Physician	258413	NY
2	208600000X	Surgery Physician	25MA09690300	NJ

General Provider Information

NPI Number	:	1992933386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN MARK YOZAWITZ M.D.

Provider Business Mailing Address
First Line	:	410 LAKEVILLE RD STE 310
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1103
Country	:	US
Telephone Number	:	718-925-6518
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 LAKEVILLE RD STE 310
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1103
Country	:	US
Telephone Number	:	718-925-6518
Fax Number	:

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

Provider Enumeration Date	:	06/24/2009
Last Update Date	:	07/21/2022

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