Provider Demographics
NPI:1982840724
Name:KOO, HYE K
Entity Type:Individual
Prefix:
First Name:HYE
Middle Name:K
Last Name:KOO
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 1:253 W 72ND ST
Mailing Address - Street 2:#GROUND FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2705
Mailing Address - Country:US
Mailing Address - Phone:212-769-1174
Mailing Address - Fax:212-769-1463
Practice Address - Street 1:253 W 72ND ST
Practice Address - Street 2:#GROUND FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2705
Practice Address - Country:US
Practice Address - Phone:212-769-1174
Practice Address - Fax:212-769-1463
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007941-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician