Individual
JEROME P. YATSKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 CEDAR ST SE STE 7600, PRESBYTERIAN HEART GROUP (PHG), ALBUQUERQUE, NM 87106-4921
(505) 563-2500
(505) 563-2599
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
92380
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E5897
—
NM
Enumeration date
10/03/2006
Last updated
05/24/2024
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