Provider Demographics
NPI:1083313613
Name:SOBA, YOLANDA (NURSE)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:SOBA
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 CROSS BRONX EXPY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-5053
Mailing Address - Country:US
Mailing Address - Phone:917-232-8702
Mailing Address - Fax:
Practice Address - Street 1:1968 CROSS BRONX EXPY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-5053
Practice Address - Country:US
Practice Address - Phone:917-232-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY573823163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool