Provider Demographics
NPI:1013918762
Name:GASPAR-YOO, VICENTA CANDELARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:VICENTA
Middle Name:CANDELARIO
Last Name:GASPAR-YOO
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 1:1301 CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1152
Mailing Address - Country:US
Mailing Address - Phone:412-235-5885
Mailing Address - Fax:412-235-5886
Practice Address - Street 1:1301 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1152
Practice Address - Country:US
Practice Address - Phone:412-235-5885
Practice Address - Fax:412-235-5886
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077887G208100000X
PAMD058330L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2190114Medicaid
OHGA4018521Medicare ID - Type Unspecified
OH2190114Medicaid