Provider Demographics
NPI:1891792115
Name:YANNUCCI, FRANK (DPM)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:YANNUCCI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-0080
Mailing Address - Country:US
Mailing Address - Phone:330-726-3668
Mailing Address - Fax:330-726-3669
Practice Address - Street 1:755 BOARDMAN CANFIELD RD
Practice Address - Street 2:BUILDING F UNIT 1
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4300
Practice Address - Country:US
Practice Address - Phone:330-726-3668
Practice Address - Fax:330-726-3669
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.00-3061213E00000X
WV362213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000376872OtherANTHEMBCBS
PA01801211Medicaid
OH2197939Medicaid
OHP00261326Medicare PIN
OH000000376872OtherANTHEMBCBS
PA01801211Medicaid
OH4143412Medicare PIN