Provider Demographics
NPI:1619282548
Name:DR GREGORY M YURICEK AND ASSOCIATES INC
Entity Type:Organization
Organization Name:DR GREGORY M YURICEK AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YURICEK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-652-2441
Mailing Address - Street 1:5555 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4804
Mailing Address - Country:US
Mailing Address - Phone:330-652-2441
Mailing Address - Fax:330-652-5544
Practice Address - Street 1:5555 YOUNGSTOWN WARREN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4804
Practice Address - Country:US
Practice Address - Phone:330-652-2441
Practice Address - Fax:330-652-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5985261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty