Provider Demographics
NPI:1588797989
Name:GULLETH, YUSUF M (MD)
Entity type:Individual
Prefix:
First Name:YUSUF
Middle Name:M
Last Name:GULLETH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE ST, FL 8
Practice Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-5004
Practice Address - Fax:617-789-5088
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2025-08-07
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Provider Licenses
StateLicense IDTaxonomies
MA243625207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110086234AMedicaid