Individual
ELIZABETH C YASEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
186 MEDICAL VILLAGE DRIVE, NEWPORT, VT 05855-9236
(802) 334-3520
(802) 334-3512
Mailing address
186 MEDICAL VILALGE DRIVE, SUITE 1, NEWPORT, VT 05855-9236
(802) 334-3580
(802) 334-3281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
055-0031382
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
VT
Enumeration date
04/16/2018
Last updated
04/23/2021
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