Provider Demographics
NPI:1750524302
Name:YURI FINK MEDICAL PC
Entity type:Organization
Organization Name:YURI FINK MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-648-0612
Mailing Address - Street 1:4078 NOSTRAND AVE
Mailing Address - Street 2:APT. 2 B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2277
Mailing Address - Country:US
Mailing Address - Phone:718-648-0612
Mailing Address - Fax:
Practice Address - Street 1:4078 NOSTRAND AVE
Practice Address - Street 2:APT. 2 B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2277
Practice Address - Country:US
Practice Address - Phone:718-648-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2010-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100001418Medicare UPIN