Individual
YAEL VIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
116 NORTH BEACON STREET, BRIGHTON, MA 02135
(617) 783-5200
(617) 783-5202
Mailing address
116 NORTH BEACON STREET, BRIGHTON, MA 02135
(617) 783-5200
(617) 783-5202
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
236881
NY
208600000X
Surgery Physician
Primary
236881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000691401
MEDICARE PTAN
MA
01
—
212277
MEDICAL LICENSE
MA
05
—
2167484
—
MA
Enumeration date
01/17/2006
Last updated
03/30/2009
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