Healthcare Provider Details

I. General information

NPI: 1073989869
Provider Name (Legal Business Name): SOKA YU DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2015
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 10TH AVE SUITE 2T
NEW YORK NY
10019-1147
US

IV. Provider business mailing address

1000 10TH AVE STE 10G
NEW YORK NY
10019-1147
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-6500
  • Fax: 212-523-7182
Mailing address:
  • Phone: 212-241-2627
  • Fax: 646-537-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number306947
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: