Provider Demographics
NPI:1750583118
Name:YURKANIN, GABRIELA (DPM/OWNER)
Entity type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:
Last Name:YURKANIN
Suffix:
Gender:F
Credentials:DPM/OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1761
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-0761
Mailing Address - Country:US
Mailing Address - Phone:570-288-8881
Mailing Address - Fax:570-288-8065
Practice Address - Street 1:201 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1509
Practice Address - Country:US
Practice Address - Phone:570-283-3222
Practice Address - Fax:866-245-8762
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005775213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA17568OtherELDER HEALTH/BRAVO
PA231365971OtherOXFORD HEALTH PLAN
PA7501968OtherAETNA PPO
PA1664032OtherAETNA
PA231365971OtherUNITED HEALTH CARE
PAME1975941OtherBLUE CROSS BLUE SHIELD
PA2855189000OtherKEYSTONE HEALTH PLAN EAST
PA28824OtherHEALTH PARTNERS
PA1019400110001Medicaid
PA31776OtherKEYSTONE MERCY
PA3Y7887OtherHEALTH NET
PA4470614OtherCIGNA
PA231365971OtherOXFORD HEALTH PLAN