Provider Demographics
NPI:1275798720
Name:FINK, YURI SERGEY (MD)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:SERGEY
Last Name:FINK
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:PO BOX 649
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-0649
Mailing Address - Country:US
Mailing Address - Phone:646-267-0210
Mailing Address - Fax:
Practice Address - Street 1:4078 NOSTRAND AVE
Practice Address - Street 2:APT. 2 B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2277
Practice Address - Country:US
Practice Address - Phone:718-648-0612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03023489Medicaid