Provider Demographics
NPI:1629815832
Name:YEREMEN, YURI V (OT)
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:V
Last Name:YEREMEN
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:YURIY
Other - Middle Name:V
Other - Last Name:YEREMENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38 PROCTOR AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6134
Mailing Address - Country:US
Mailing Address - Phone:646-633-2203
Mailing Address - Fax:
Practice Address - Street 1:596 SHELDON RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-8011
Practice Address - Country:US
Practice Address - Phone:802-330-4028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000557225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist