Provider Demographics
NPI:1467934422
Name:OH, ESTHER SOOYOUNG (RN)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:SOOYOUNG
Last Name:OH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:S
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:58 W MILLPAGE DR
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-4818
Mailing Address - Country:US
Mailing Address - Phone:516-314-6846
Mailing Address - Fax:
Practice Address - Street 1:58 W MILLPAGE DR
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-4818
Practice Address - Country:US
Practice Address - Phone:516-314-6846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY573478163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse