Provider Demographics
NPI:1588347033
Name:AMEZAGA, YOLANDA (MD)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:AMEZAGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE.
Mailing Address - Street 2:YAMINS 2ND FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2610
Mailing Address - Country:US
Mailing Address - Phone:617-667-5048
Mailing Address - Fax:617-667-5050
Practice Address - Street 1:330 BROOKLINE AVE.
Practice Address - Street 2:YAMINS 2ND FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2610
Practice Address - Country:US
Practice Address - Phone:617-667-5048
Practice Address - Fax:617-667-5050
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program