Provider Demographics
NPI:1942972369
Name:VAZQUEZ, YUNEISY (MD)
Entity Type:Individual
Prefix:
First Name:YUNEISY
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YUNEISY
Other - Middle Name:
Other - Last Name:VAZQUEZ CAMACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 CROWN DR UNIT 406
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5480
Mailing Address - Country:US
Mailing Address - Phone:305-986-6245
Mailing Address - Fax:
Practice Address - Street 1:68 NEW EDGERLY RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-3503
Practice Address - Country:US
Practice Address - Phone:617-262-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859220122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist