Provider Demographics
NPI:1114945771
Name:SCHOOLOV, YURI (MD)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:SCHOOLOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WASHINGTON ST
Mailing Address - Street 2:APT. 6-B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1585
Mailing Address - Country:US
Mailing Address - Phone:787-724-0106
Mailing Address - Fax:
Practice Address - Street 1:435 PONCE DE LEON AVE
Practice Address - Street 2:HOSPITAL PAVIA HATO REY
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-724-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR153312085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH56060Medicare UPIN