Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 14486 | MA |
NPI | 1033260385 |
---|---|
Provider Name | Steven E Yarmosky |
First Address | Pittsfield, MA 01201-6551 |
Second Address | Pittsfield, MA 01201-6551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00302 | DELTA DENTAL OF MA (01) | MA |
591180 | UNITED CONCORDIA (01) | |
X06492YA | BCBS OF MA (01) | MA |