Provider Demographics
NPI:1437240512
Name:YERACARIS, YOUKO G (MD)
Entity Type:Individual
Prefix:
First Name:YOUKO
Middle Name:G
Last Name:YERACARIS
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 1:37 BERESFORD RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2622
Mailing Address - Country:US
Mailing Address - Phone:617-731-5100
Mailing Address - Fax:
Practice Address - Street 1:32 KENT ST
Practice Address - Street 2:STE 108
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7944
Practice Address - Country:US
Practice Address - Phone:617-731-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF75614Medicare UPIN
MAA23066Medicare PIN