Provider Demographics
NPI:1588896914
Name:JOSEPH YERETSIAN, PC
Entity type:Organization
Organization Name:JOSEPH YERETSIAN, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:YERETSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-507-1472
Mailing Address - Street 1:361 NEWBURY ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-2727
Mailing Address - Country:US
Mailing Address - Phone:617-865-4910
Mailing Address - Fax:617-507-1426
Practice Address - Street 1:361 NEWBURY ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-2727
Practice Address - Country:US
Practice Address - Phone:617-865-4910
Practice Address - Fax:617-507-1426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2358192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty