Basic Information
| Provider Information | |||||||||
| NPI: | 1477527281 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YUSKEVICH | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 994 SANDY RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | DOYLESTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189012433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154899225 | ||||||||
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| Practice Location | |||||||||
| Address1: | ERPG ANESTHESIA DEPARTMENT | ||||||||
| Address2: | 763 JOHNSONBURG ROAD | ||||||||
| City: | ST. MARYS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8147888577 | ||||||||
| FaxNumber: | 8147888092 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | MD051571L | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | BY4569945 | 01 | PA | DEA | OTHER |