Provider Demographics
NPI:1619190915
Name:YURTER, BORA A (OD)
Entity type:Individual
Prefix:DR
First Name:BORA
Middle Name:A
Last Name:YURTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 QUEENS BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4910
Mailing Address - Country:US
Mailing Address - Phone:718-592-5200
Mailing Address - Fax:718-592-7902
Practice Address - Street 1:9015 QUEENS BLVD
Practice Address - Street 2:COHEN'S FASHION OPTICAL #6
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4900
Practice Address - Country:US
Practice Address - Phone:718-592-5200
Practice Address - Fax:718-592-7902
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005905-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist