Provider Demographics
NPI:1083894166
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:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:YANNUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-534-3990
Mailing Address - Street 1:30 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1653
Mailing Address - Country:US
Mailing Address - Phone:330-534-3990
Mailing Address - Fax:330-534-3994
Practice Address - Street 1:30 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1653
Practice Address - Country:US
Practice Address - Phone:330-534-3990
Practice Address - Fax:330-534-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003061213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000376872OtherANTHEMBCBS
OH000000376872OtherANTHEMBCBS
OH5526290001Medicare NSC
OHDD9349Medicare PIN