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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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1871248567
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH YERETSIAN, PC
Provider Business Mailing Address
First Line : 4770 BASELINE RD STE 300
Second Line :
City : BOULDER
State : CO
Zip : 80303-2669
Country : US
Telephone Number : 720-798-4516
Fax Number :
Provider Business Practice Location Address
First Line : 1600 BROADWAY STE 1600
Second Line :
City : DENVER
State : CO
Zip : 80202-4916
Country : US
Telephone Number : 720-288-0052
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSEPH YERETSIAN
Credential : MD
Telephone Number : 617-507-1472
Provider Enumeration Date : 02/21/2022
Last Update Date : 02/21/2022

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