Healthcare Provider Details

I. General information

NPI: 1407416795
Provider Name (Legal Business Name): HILARIO YANKEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 COTTMAN AVE
PHILADELPHIA PA
19111-2497
US

IV. Provider business mailing address

333 COTTMAN AVE
PHILADELPHIA PA
19111-2497
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-3016
  • Fax:
Mailing address:
  • Phone: 215-728-3016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD484285
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: