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NPI Code Detail

MEDICARE: LUIS VACCARELLO M.D.

MEDICARE: LUIS VACCARELLO 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
1207VX0201XGynecologic Oncology Physician35063432OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
235063432OTHEROHSTATE MEDICAL LICENSE

General Provider Information

NPI Number : 1225034622
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS VACCARELLO M.D.
Provider Business Mailing Address
First Line : 2257 OLD STONE RD
Second Line :
City : BLACKLICK
State : OH
Zip : 43004-9558
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3100 PLAZA PROPERTIES BLVD
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1531
Country : US
Telephone Number : 614-383-6000
Fax Number : 614-383-6001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 11/03/2023

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Directions to “ LUIS VACCARELLO M.D.” Practice Location

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