| Doctor Name: | DORIS YANETH VACA |
| NPI Number: | 1003252073 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 649357-1 |
| Business Practice Address: | 147 E Broadway Monticello, NY - 127018802 |
| Business Phone Number: | 8458662511 |
| Business Fax Number: | |
| Mailing Address: | 147 E Broadway, MONTICELLO |
| State: | NY |
| Postal Code: | 127018802 |
| Phone Number: | 8458662511 |
| Fax Number: | |
| NPI Enumeration Date: | 05/17/2013 |
| NPI Last Update Date: | 05/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | 649357-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |