Provider Demographics
NPI:1568622801
Name:FUKUDA, YOKO (MD)
Entity Type:Individual
Prefix:
First Name:YOKO
Middle Name:
Last Name:FUKUDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YOKO
Other - Middle Name:
Other - Last Name:KORENAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0911
Mailing Address - Country:US
Mailing Address - Phone:207-303-3200
Mailing Address - Fax:207-250-2140
Practice Address - Street 1:155 BORTHWICK AVE STE C
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7156
Practice Address - Country:US
Practice Address - Phone:603-828-0100
Practice Address - Fax:603-828-0111
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD23455207RH0003X
NH16165207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology