Basic Information
| Provider Information | |||||||||
| NPI: | 1407832595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VACCA | ||||||||
| FirstName: | VINCENT | ||||||||
| MiddleName: | FIORE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2153 DEPT 40338 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352879386 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233101642 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1524 ATWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | JOHNSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029193228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013830400 | ||||||||
| FaxNumber: | 4013830410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2005 | ||||||||
| LastUpdateDate: | 08/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD03694 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.