Provider Demographics
NPI:1285613794
Name:MCDERMOTT, ANN YELMOKAS (PHD, LDN)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:YELMOKAS
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:PHD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1207
Mailing Address - Country:US
Mailing Address - Phone:617-262-7172
Mailing Address - Fax:
Practice Address - Street 1:115 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-1207
Practice Address - Country:US
Practice Address - Phone:617-262-7172
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU 1320133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education