Provider Demographics
NPI:1255380879
Name:MAZUR, YURI (MD)
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:MAZUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:IOURII
Other - Middle Name:
Other - Last Name:MAZOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17 MOLSBURY LN
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-8763
Mailing Address - Country:US
Mailing Address - Phone:732-491-5314
Mailing Address - Fax:
Practice Address - Street 1:17 MOLSBURY LN
Practice Address - Street 2:
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08510-8763
Practice Address - Country:US
Practice Address - Phone:732-491-5314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA078785002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI02068Medicare UPIN
NJ094079Medicare ID - Type Unspecified