Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00610300 | NJ |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 308083 | NY |
NPI | 1003272865 |
---|---|
Provider Name | Eunae Ko |
First Address | New York, NY 10001-4703 |
Second Address | New York, NY 10001-4703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2016 |
Last Update Date | 31/01/2022 |