Individual
MARC YACOVONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Mailing address
25 TOWN CMN, GORHAM, ME 04038-2671
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2265881
MA
390200000X
Student in an Organized Health Care Education/Training Program
RN67056
ME
Other
Enumeration date
01/19/2016
Last updated
10/28/2019
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