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Organization
YANKEE MEDICAL INC
Active
Organization
YANKEE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN NICHOLAS FICOCIELLO CPO (PRESIDENT)
(802) 863-4591
Entity
Organization
Contact information
Practice address
165 MECHANIC ST, LEBANON, NH 03766-1509
(603) 448-8853
Mailing address
276 NORTH AVE, BURLINGTON, VT 05401-2918
(802) 863-4591
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007330
BCBS VT
VT
05
—
0007330
—
VT
05
—
00358269
—
NY
01
—
1200915YONH01
NH BCBS
NH
01
—
1505
MVP
VT
05
—
99007330
—
NH
Enumeration date
12/13/2006
Last updated
06/18/2008
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