Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 40368 | MA |
NPI | 1801877626 |
---|---|
Provider Name | Dr. Tsunehiro Yasuda |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 23/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040368 | TUFTS HEALTH PLAN (01) | MA |
2056437 | (05) | MA |
A66972 | (02) | |
M09584 | BCBS MA (01) | MA |