Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25MA08777400 | NJ |
Y | 208600000X | Surgeon | 25MA08777400 | NJ |
NPI | 1003062050 |
---|---|
Provider Name | Dr. Basil Michael Yurcisin II |
First Address | Millburn, NJ 07041-1737 |
Second Address | Millburn, NJ 07041-1737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2008 |
Last Update Date | 30/06/2011 |