Individual
IGOR YATSKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., P.T.
Contact information
Practice address
120 DUDLEY ST STE 201, PROVIDENCE, RI 02905-2431
(401) 941-1347
(617) 445-7874
Mailing address
120 DUDLEY ST, STE 201, PROVIDENCE, RI 02905-2431
(617) 442-3462
(617) 445-7874
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11044
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0703061
—
MA
01
—
AA33405
HARVARD
MA
01
—
Y67378
BCBS
MA
Enumeration date
07/24/2006
Last updated
01/26/2022
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