Provider Demographics
NPI:1164034914
Name:JOSEPH YERETSIAN, PC
Entity Type:Organization
Organization Name:JOSEPH YERETSIAN, PC
Other - Org Name:
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:970-549-0235
Mailing Address - Street 1:155 BOARDWALK DR STE 400
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3040
Mailing Address - Country:US
Mailing Address - Phone:970-549-0235
Mailing Address - Fax:617-507-1426
Practice Address - Street 1:155 BOARDWALK DR STE 400
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3040
Practice Address - Country:US
Practice Address - Phone:970-549-0235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty