Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 210814 | MA |
N | 2080P0203X | Pediatric Critical Care Doctor | 210814 | MA |
NPI | 1154303576 |
---|---|
Provider Name | Dr. Yuka-Marie Vinagre |
First Address | Worcester, MA 01608-1216 |
Second Address | Worcester, MA 01655-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2005 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2011905 | (05) | MA |
H86171 | (02) | MA |