Provider Demographics
NPI:1376755991
Name:EDUARDO YATCO, PA
Entity Type:Organization
Organization Name:EDUARDO YATCO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:YATCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-629-6701
Mailing Address - Street 1:8866 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3655
Mailing Address - Country:US
Mailing Address - Phone:302-629-6701
Mailing Address - Fax:302-629-6703
Practice Address - Street 1:8866 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3655
Practice Address - Country:US
Practice Address - Phone:302-629-6701
Practice Address - Fax:302-629-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10001647208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000177802Medicaid
DE0000177802Medicaid