Provider Demographics
NPI:1942504196
Name:YOSHIHARU AKABANE PC
Entity Type:Organization
Organization Name:YOSHIHARU AKABANE PC
Other - Org Name:YOSHIHARU AKABANE MD.,PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOSHIHARU
Authorized Official - Middle Name:
Authorized Official - Last Name:AKABANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-595-6764
Mailing Address - Street 1:330 LYNNWAY
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1706
Mailing Address - Country:US
Mailing Address - Phone:781-593-6451
Mailing Address - Fax:781-593-0071
Practice Address - Street 1:330 LYNNWAY
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1706
Practice Address - Country:US
Practice Address - Phone:781-593-6451
Practice Address - Fax:781-593-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40233174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1004500OtherNEIGHBORHOOD HEALTH PLAN
MA043101892OtherHARVARD PILGRIM HEALTHCARE
MA043101892OtherPACIFIC CARE
MA1004500OtherFALLON COMMUNITY HEALTH PLAN
MA992932OtherNETEORK HEALTH
MA000134OtherHP/VAL.OPT
MA120002OtherBC/BS OF MASS (HMO)
MA0139017Medicaid
MA120002OtherBLUE CROSS/BLUE SHIELD (INDEMITY)
MA709709OtherTUFTS
MA12000AKOtherMEDICARE ID UNSPECIFIED
MA206283OtherMC
MA1004500OtherNEIGHBORHOOD HEALTH PLAN