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General NPI Number Information
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NPI Number | 1841657186
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Entity Type | Individual
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Provider Name | YURI HOSOKAWA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2016
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Last Update Date | 01/18/2016
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Provider Practice Location Address
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Address Line | 2110 HILLSIDE RD UNIT 3008
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City | STORRS
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State | CT
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Zip | 06269-3008
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Country | US
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Telephone | 860-486-6514
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Fax |
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Provider Business Mailing Address
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Address Line | 232 BROAD ST APT 3B
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City | DANIELSON
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State | CT
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Zip | 06239-3001
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Country | US
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Telephone | 479-387-6220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000887
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License Number State | CT
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