Provider Demographics
NPI:1144777533
Name:YUCIS, PETER (DPT)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:YUCIS
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 1:2338 FERNWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-1358
Mailing Address - Country:US
Mailing Address - Phone:856-952-8372
Mailing Address - Fax:
Practice Address - Street 1:2338 FERNWOOD AVE
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-1358
Practice Address - Country:US
Practice Address - Phone:856-952-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01670400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist