Healthcare Provider Details

I. General information

NPI: 1427873496
Provider Name (Legal Business Name): I JU KUO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 7TH AVE FL 18
NEW YORK NY
10001-5086
US

IV. Provider business mailing address

333 7TH AVE FL 18
NEW YORK NY
10001-5086
US

V. Phone/Fax

Practice location:
  • Phone: 917-286-5206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number025597
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: