Provider Demographics
NPI:1639474786
Name:YOSHIDA, YUKO (SLP)
Entity Type:Individual
Prefix:
First Name:YUKO
Middle Name:
Last Name:YOSHIDA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 RIVERSIDE DR APT 4F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1049
Mailing Address - Country:US
Mailing Address - Phone:646-294-5223
Mailing Address - Fax:
Practice Address - Street 1:455 SOUTHERN BLVD
Practice Address - Street 2:225
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4911
Practice Address - Country:US
Practice Address - Phone:718-585-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020138-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist