Individual
YADIRA E. ACEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13 HIGH ST, PORTLAND, CT 06480-1616
(860) 358-7100
(860) 358-8321
Mailing address
13 HIGH ST, PORTLAND, CT 06480-1616
(860) 358-7100
(860) 358-8321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49520
CT
208M00000X
Hospitalist Physician
49520
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49520
CT LICENSE
CT
Enumeration date
01/21/2008
Last updated
03/16/2017
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