Provider Demographics
NPI:1467686907
Name:MILLENNIUM GYNECOLOGY P.L.L.C.
Entity Type:Organization
Organization Name:MILLENNIUM GYNECOLOGY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YUZEFOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-470-6453
Mailing Address - Street 1:8101 HINSON FARM RD STE 313
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3408
Mailing Address - Country:US
Mailing Address - Phone:571-730-4354
Mailing Address - Fax:
Practice Address - Street 1:3359 ROUNDTREE ESTATES CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3550
Practice Address - Country:US
Practice Address - Phone:571-730-4354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241614207VG0400X
FLME99325207VG0400X
NY252177-1207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty