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NPI Code Detail

MEDICARE: HENRY SOE THUKHA MD

MEDICARE: HENRY SOE THUKHA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207RG0300XGeriatric Medicine (Internal Medicine) Physician266101NY

General Provider Information

NPI Number : 1710114624
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY SOE THUKHA MD
Provider Business Mailing Address
First Line : 120 W 106TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10025-3923
Country : US
Telephone Number : 212-870-4715
Fax Number :
Provider Business Practice Location Address
First Line : 120 W 106TH ST
Second Line : JEWISH HOME LIFECARE
City : NEW YORK
State : NY
Zip : 10025-3923
Country : US
Telephone Number : 212-870-4715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2009
Last Update Date : 07/11/2013

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