Provider Demographics
NPI:1437686029
Name:YE, BO RA (MD)
Entity Type:Individual
Prefix:
First Name:BO RA
Middle Name:
Last Name:YE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BORA
Other - Middle Name:
Other - Last Name:YE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:99 GOVE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-2145
Mailing Address - Country:US
Mailing Address - Phone:734-780-5779
Mailing Address - Fax:
Practice Address - Street 1:450 CLARKSON AVE DEPT OF
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program