Vacanti, Joseph Philip

Vacanti, Joseph Philip is an individual health care provider with primary practice located at 55 Fruit St Wrn 1157, Boston MA 02114-2621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Vacanti, Joseph Philip can be contacted via phone (617) 724-1725.

Contact Information

Primary practice address
55 Fruit St Wrn 1157 Boston MA 02114-2621
Phone: (617) 724-1725
Fax: (617) 726-7593
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 39234 Massachusetts

Profile Details

NPI number 1396736906
LBN Legal business name Vacanti, Joseph Philip
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jan 3rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396736906 NPPES
Massachusetts MEDICAID 2055481
Massachusetts Other 702960
Massachusetts Other C05171

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