Individual provider Active NPI

Jennifer Leigh Yurcik, PTA

  • Specialist
  • Honesdale, PA
National Provider Identifier
1255646162
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
TEI000396 Issued in PA
Practice address
232 Sunrise Ave
Honesdale, PA 18431-1085
Phone
(570) 251-8003
Fax
(570) 251-8005
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X TEI000396 PA Primary

Addresses

Primary practice location

232 Sunrise Ave
Honesdale, PA 18431-1085

Mailing address

232 Sunrise Ave
Honesdale, PA 18431-1085
Phone (570) 251-8003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TEI000396PAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1255646162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 SUNRISE AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311085",
            "telephone_number": "570-251-8003",
            "fax_number": "570-251-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 SUNRISE AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311085",
            "telephone_number": "570-251-8003",
            "fax_number": "570-251-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YURCIK",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "TEI000396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.