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NPI Code Detail

MEDICARE: JOSEPH YERETSIAN, PC

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
12084P0800XPsychiatry Physician
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1770055030
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH YERETSIAN, PC
Provider Business Mailing Address
First Line : 4770 BASELINE RD STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80303-2668
Country : US
Telephone Number : 720-893-0842
Fax Number : 617-507-1426
Provider Business Practice Location Address
First Line : 1309 BEACON ST STE 300
Second Line :
City : BROOKLINE
State : MA
Zip : 02446-5252
Country : US
Telephone Number : 857-267-8820
Fax Number : 617-507-1426
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSEPH YERETSIAN
Credential : MD
Telephone Number : 617-507-1472
Provider Enumeration Date : 12/27/2018
Last Update Date : 01/02/2020

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