Provider Demographics
NPI:1962726828
Name:YAROSH, DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:YAROSH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:YAROSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:124 E 84TH ST APT 1D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0918
Mailing Address - Country:US
Mailing Address - Phone:212-772-3029
Mailing Address - Fax:
Practice Address - Street 1:124 E 84TH ST APT 1D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0918
Practice Address - Country:US
Practice Address - Phone:212-772-3029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical