MEDICARE: YUKO ISHIKAWA

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
1	106H00000X	Marriage & Family Therapist	001433	NY

General Provider Information

NPI Number	:	1265940522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUKO ISHIKAWA

Provider Business Mailing Address
First Line	:	245 W 29TH ST RM 405
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-5437
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 W 29TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-5208
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2018
Last Update Date	:	10/11/2019

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Directions to “ YUKO ISHIKAWA ” Practice Location

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