Provider Demographics
NPI:1386625556
Name:TWERSKY, YITZHAK DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:YITZHAK
Middle Name:DAVID
Last Name:TWERSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 CENTRAL AVE
Mailing Address - Street 2:204
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-8507
Mailing Address - Country:US
Mailing Address - Phone:516-371-1973
Mailing Address - Fax:516-239-6866
Practice Address - Street 1:290 CENTRAL AVE
Practice Address - Street 2:204
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-8507
Practice Address - Country:US
Practice Address - Phone:516-371-1973
Practice Address - Fax:516-239-6866
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY172791207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01274804Medicaid
NY01274804Medicaid
NYE74728Medicare UPIN