Provider Demographics
NPI:1750314878
Name:ENDO, YUKA (MD)
Entity Type:Individual
Prefix:
First Name:YUKA
Middle Name:
Last Name:ENDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YUKA
Other - Middle Name:
Other - Last Name:MOCHIZUKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8 PROSPECT ST # 1184
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3925
Mailing Address - Country:US
Mailing Address - Phone:603-577-2039
Mailing Address - Fax:603-882-5656
Practice Address - Street 1:8 PROSPECT ST # 1184
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3925
Practice Address - Country:US
Practice Address - Phone:603-577-2039
Practice Address - Fax:603-882-5656
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12695207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30205246Medicaid
NH30205246Medicaid