Healthcare Provider Details

I. General information

NPI: 1861145930
Provider Name (Legal Business Name): YOTAM BLOCK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2022
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MAIN ST
FLORENCE MA
01062-1466
US

IV. Provider business mailing address

70 MAIN ST
FLORENCE MA
01062-1466
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-8400
  • Fax: 866-644-0872
Mailing address:
  • Phone: 413-586-8400
  • Fax: 866-644-0872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: