Healthcare Provider Details
I. General information
NPI: 1306088042
Provider Name (Legal Business Name): YESTERMORROW PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2009
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 MAIN ST SUITE #18
EAST GREENWICH RI
02818-3161
US
IV. Provider business mailing address
1050 MAIN ST SUITE #18
EAST GREENWICH RI
02818-3161
US
V. Phone/Fax
- Phone: 401-886-9669
- Fax: 401-886-9779
- Phone: 401-886-9669
- Fax: 401-886-9779
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QB0002X |
| Taxonomy | Obesity Medicine (Family Medicine) Physician |
| License Number | MD10390 |
| License Number State | RI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD11488 |
| License Number State | RI |
VIII. Authorized Official
Name:
JENNIFER
PIACITELLI
Title or Position: OFFICE MANAGER
Credential:
Phone: 401-886-9669