MEDICARE: JOSEPH YERETSIAN, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	235819	MA

General Provider Information

NPI Number	:	1588896914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH YERETSIAN, PC

Provider Business Mailing Address
First Line	:	361 NEWBURY ST FL 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-2727
Country	:	US
Telephone Number	:	617-865-4910
Fax Number	:	617-507-1426

Provider Business Practice Location Address
First Line	:	361 NEWBURY ST FL 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-2727
Country	:	US
Telephone Number	:	617-865-4910
Fax Number	:	617-507-1426

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH YERETSIAN
Credential	:	M.D.
Telephone Number	:	617-507-1472

Provider Enumeration Date	:	08/18/2009
Last Update Date	:	02/05/2024

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