Provider Demographics
NPI:1811302649
Name:YANOK, TONYA FAYE (DPT)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:FAYE
Last Name:YANOK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 WASHINGTON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6022
Mailing Address - Country:US
Mailing Address - Phone:781-762-0471
Mailing Address - Fax:781-762-8072
Practice Address - Street 1:910 WASHINGTON ST STE 104
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6022
Practice Address - Country:US
Practice Address - Phone:781-762-0471
Practice Address - Fax:781-762-8072
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist