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NPI Code Detail

MEDICARE: DR. VINCENT J YAKAVONIS M.D.

MEDICARE: DR. VINCENT J YAKAVONIS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianRI5999RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679572838
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINCENT J YAKAVONIS M.D.
Provider Business Mailing Address
First Line : 120 CENTERVILLE RD
Second Line :
City : WARWICK
State : RI
Zip : 02886-4336
Country : US
Telephone Number : 401-738-3730
Fax Number : 401-738-3777
Provider Business Practice Location Address
First Line : 120 CENTERVILLE RD
Second Line :
City : WARWICK
State : RI
Zip : 02886-4336
Country : US
Telephone Number : 401-738-3730
Fax Number : 401-738-3777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 11/10/2009

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