Provider Demographics
NPI:1366847105
Name:YUSHKEVICH, YAROSLAV
Entity Type:Individual
Prefix:
First Name:YAROSLAV
Middle Name:
Last Name:YUSHKEVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7460 S COOLIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5231
Mailing Address - Country:US
Mailing Address - Phone:720-427-0266
Mailing Address - Fax:303-671-0237
Practice Address - Street 1:7460 S COOLIDGE WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5231
Practice Address - Country:US
Practice Address - Phone:720-427-0266
Practice Address - Fax:303-671-0237
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic