Provider Demographics
NPI:1376176156
Name:YI, NUO
Entity Type:Individual
Prefix:
First Name:NUO
Middle Name:
Last Name:YI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 N OAKLAND AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2826
Mailing Address - Country:US
Mailing Address - Phone:570-801-8217
Mailing Address - Fax:
Practice Address - Street 1:3402 N OAKLAND AVE APT 204
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-2826
Practice Address - Country:US
Practice Address - Phone:570-801-8217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program