Individual
MR. VINCENT J YACONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
33 BRUNSWICK WOODS DR, EAST BRUNSWICK, NJ 08816-5601
(732) 257-4330
Mailing address
33 BRUNSWICK WOODS DR, EAST BRUNSWICK, NJ 08816-5601
(732) 257-4330
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NN06224900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142441
—
NJ
01
—
222130958
TAX ID
NJ
Enumeration date
03/05/2007
Last updated
02/18/2009
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