Provider Demographics
NPI:1881634681
Name:YORKE, MICHAEL D (MPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:YORKE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 LACEY RD
Mailing Address - Street 2:STE 9-12
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2947
Mailing Address - Country:US
Mailing Address - Phone:732-849-0700
Mailing Address - Fax:732-849-4718
Practice Address - Street 1:67 LACEY RD
Practice Address - Street 2:STE 9-12
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2947
Practice Address - Country:US
Practice Address - Phone:732-849-0700
Practice Address - Fax:732-849-4718
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00877900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092523Medicare ID - Type UnspecifiedGROUP IDENTIFICATION #
NJ081419UD8Medicare UPIN
NJ081419Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #