Provider Demographics
NPI:1578645016
Name:YURI USHER PT PC
Entity Type:Organization
Organization Name:YURI USHER PT PC
Other - Org Name:OPTIMAL REHABILITATION PT PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:USHER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-650-5756
Mailing Address - Street 1:114 HARDS LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1315
Mailing Address - Country:US
Mailing Address - Phone:516-650-5756
Mailing Address - Fax:516-239-1903
Practice Address - Street 1:114 HARDS LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1315
Practice Address - Country:US
Practice Address - Phone:516-650-5756
Practice Address - Fax:516-239-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013636261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy