Individual
YURIY Y DANKULICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6161
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6161
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
25MP00523900
NJ
363AM0700X
Medical Physician Assistant
Primary
MA064787
PA
Other
Enumeration date
06/11/2019
Last updated
10/24/2023
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