Provider Demographics
NPI:1902854326
Name:YESTREPSKY, JOYCE (OD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:YESTREPSKY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5714 15 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5705
Mailing Address - Country:US
Mailing Address - Phone:586-268-4466
Mailing Address - Fax:586-268-9530
Practice Address - Street 1:5714 15 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5705
Practice Address - Country:US
Practice Address - Phone:586-268-4466
Practice Address - Fax:586-268-9530
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003789152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist