Provider Demographics
NPI:1588608392
Name:YURKOFSKY, LYNN M (DPM, PA)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:YURKOFSKY
Suffix:
Gender:F
Credentials:DPM, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 WAGNER FARM RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-2048
Mailing Address - Country:US
Mailing Address - Phone:410-638-2204
Mailing Address - Fax:410-638-2446
Practice Address - Street 1:1206 YORK RD
Practice Address - Street 2:L-2
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6217
Practice Address - Country:US
Practice Address - Phone:410-638-2204
Practice Address - Fax:410-638-2446
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01275213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD559701301Medicaid
MD47-0875968OtherTAX ID
MD69773601OtherBCBS
MD47-0875968OtherTAX ID
MD69773601OtherBCBS