Individual
JONATHAN D. VACIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 GROTON RD, AYER, MA 01432-1168
(978) 784-9000
Mailing address
60 HIGH ST, ANDOVER, MA 01810-3529
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
220308
MA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
12824
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110039191A
—
MA
Enumeration date
12/12/2006
Last updated
11/30/2020
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