Healthcare Provider Details

I. General information

NPI: 1861190043
Provider Name (Legal Business Name): EUNHYE NP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BURNHAM AVE
ROSLYN HTS NY
11577-1002
US

IV. Provider business mailing address

7 BURNHAM AVE
ROSLYN HTS NY
11577-1002
US

V. Phone/Fax

Practice location:
  • Phone: 347-514-1756
  • Fax:
Mailing address:
  • Phone: 516-641-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MI KYEONG OH
Title or Position: NP
Credential:
Phone: 516-641-6965