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NPI Code Detail

MEDICARE: YVETTE PANIAGUA BA

MEDICARE: YVETTE PANIAGUA BA
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
1171M00000XCase Manager/Care Coordinator

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 : 1033441449
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVETTE PANIAGUA BA
Provider Business Mailing Address
First Line : 1313 W CHICAGO AVE
Second Line :
City : EAST CHICAGO
State : IN
Zip : 46312-3316
Country : US
Telephone Number : 219-392-4962
Fax Number :
Provider Business Practice Location Address
First Line : 1313 W CHICAGO AVE
Second Line :
City : EAST CHICAGO
State : IN
Zip : 46312-3316
Country : US
Telephone Number : 219-392-4962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2010
Last Update Date : 02/10/2010

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Directions to “ YVETTE PANIAGUA BA” Practice Location

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