Provider Demographics
NPI:1700810934
Name:YAROSLAVSKY, YURY (MD)
Entity Type:Individual
Prefix:
First Name:YURY
Middle Name:
Last Name:YAROSLAVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CARLISLE AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-3241
Mailing Address - Country:US
Mailing Address - Phone:717-792-2976
Mailing Address - Fax:717-792-2815
Practice Address - Street 1:401 CARLISLE AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-3241
Practice Address - Country:US
Practice Address - Phone:717-792-2976
Practice Address - Fax:717-792-2815
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4287092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016970630001Medicaid