Basic Information
| Provider Information | |||||||||
| NPI: | 1639625486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GURA | ||||||||
| FirstName: | YANIV | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 E 37TH ST APT 8B | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100163058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165564789 | ||||||||
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| Practice Location | |||||||||
| Address1: | 95 ARCH ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302538195 | ||||||||
| FaxNumber: | 3302530853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2016 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 57.028651 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 298794 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | FG8470469 | 01 | NY | DEA NUMBER | OTHER |