Provider Demographics
NPI:1043408461
Name:USHER, YURI (DPT)
Entity Type:Individual
Prefix:MR
First Name:YURI
Middle Name:
Last Name:USHER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HARDS LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1315
Mailing Address - Country:US
Mailing Address - Phone:516-650-5756
Mailing Address - Fax:516-239-1903
Practice Address - Street 1:114 HARDS LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1315
Practice Address - Country:US
Practice Address - Phone:516-650-5756
Practice Address - Fax:516-239-1903
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013636225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ39362Medicare UPIN
NYQ39362Medicare PIN