Provider Demographics
NPI:1043663826
Name:YIRERONG, JULIET AAFEREMWIN (MD)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:AAFEREMWIN
Last Name:YIRERONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BREWSTER ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4474
Mailing Address - Country:US
Mailing Address - Phone:401-729-2258
Mailing Address - Fax:401-729-3343
Practice Address - Street 1:439 MILL HILL AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2866
Practice Address - Country:US
Practice Address - Phone:203-334-2100
Practice Address - Fax:203-333-5864
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP03799207R00000X
CT69396207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine