Provider Demographics
NPI:1033269642
Name:FRANK YANNUCCI DPM INC
Entity Type:Organization
Organization Name:FRANK YANNUCCI DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:YANNUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-726-3668
Mailing Address - Street 1:790 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-7319
Mailing Address - Country:US
Mailing Address - Phone:330-726-3668
Mailing Address - Fax:330-726-3669
Practice Address - Street 1:790 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-7319
Practice Address - Country:US
Practice Address - Phone:330-726-3668
Practice Address - Fax:330-726-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003061213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000376872OtherANTHEMBCBS
OH2197939Medicaid
OH000000376872OtherANTHEMBCBS
OH2197939Medicaid
OHDD9349Medicare PIN