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
276 NORTH AVE, BURLINGTON, VT 05401-2918
(802) 863-4591
(802) 658-3101
Mailing address
276 NORTH AVENUE, PO BOX 1486, BURLINGTON, VT 05401-1486
(802) 863-4591
(802) 658-3101
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007330
—
VT
05
—
00358269
—
NY
01
—
1200915YONH01
DME/BCBS OF NH
NH
01
—
1505
DME/MVP
VT
05
—
7502028
—
MA
05
—
99007330
—
NH
01
—
YAV7330
DME/BCBS
VT
Enumeration date
06/20/2005
Last updated
05/07/2008
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