Provider Demographics
NPI:1619391935
Name:SOE, KYI KYI
Entity Type:Individual
Prefix:
First Name:KYI KYI
Middle Name:
Last Name:SOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 W 110TH ST APT 14G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2474
Mailing Address - Country:US
Mailing Address - Phone:212-865-1843
Mailing Address - Fax:
Practice Address - Street 1:424 W 110TH ST APT 14G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2474
Practice Address - Country:US
Practice Address - Phone:212-865-1843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY653012163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse