Provider Demographics
NPI:1790892172
Name:PORADOWSKI, YOLANDA DANUTA (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:DANUTA
Last Name:PORADOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALICE PECK DAY DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-2694
Mailing Address - Country:US
Mailing Address - Phone:603-448-3121
Mailing Address - Fax:603-448-7462
Practice Address - Street 1:5 ALICE PECK DAY DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-2901
Practice Address - Country:US
Practice Address - Phone:603-448-3122
Practice Address - Fax:603-448-7491
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14565207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30208983Medicaid
NH1790892172OtherANTHEM
VT1790892172OtherBCBS OF VT
020222791OtherCIGNA
AA155775OtherHARVARD PILGRIM
NH020222791OtherCBA
VT1016763Medicaid
200071211OtherMVP
VT1016763Medicaid
NH001366101Medicare PIN