Provider Demographics
NPI:1265594402
Name:YAVORSKY, JOHN M (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:YAVORSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:328 W SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-5638
Mailing Address - Country:US
Mailing Address - Phone:908-925-7519
Mailing Address - Fax:908-925-2842
Practice Address - Street 1:91 CENTER STREET
Practice Address - Street 2:
Practice Address - City:GARWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07027-1231
Practice Address - Country:US
Practice Address - Phone:908-789-0626
Practice Address - Fax:908-789-3123
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05872500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6825702Medicaid
NJ1K1554OtherHEALTHNET
NJ0721220000OtherAMERIHEALTH INDIVIDUAL
NJ000121254OtherHIGHMARK BLUE SHIELD INDI
NJP783147OtherOXFORD
NJF84437Medicare UPIN
NJP783147OtherOXFORD