Provider Demographics
NPI:1821025909
Name:HUNTER-YATES, JENNIFER M (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:HUNTER-YATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:30 LANCASTER STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-722-4100
Mailing Address - Fax:617-227-1134
Practice Address - Street 1:30 LANCASTER STREET
Practice Address - Street 2:SUITE 400
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-722-4100
Practice Address - Fax:617-227-1134
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA227798207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMH0629660AOtherCONTROLLED SUBSTANCE