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Individual
DR. JOSEPH PHILIP VACANTI
Active
Individual
DR. JOSEPH PHILIP VACANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
39234
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2055481
—
MA
01
—
702960
TUFTS HEALTH PLAN
MA
01
—
C05171
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
01/03/2013
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