Provider Demographics
NPI:1780758045
Name:YIU, POLINE (RPA-C)
Entity type:Individual
Prefix:MISS
First Name:POLINE
Middle Name:
Last Name:YIU
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CENTRE ST
Mailing Address - Street 2:SUITE 609
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4408
Mailing Address - Country:US
Mailing Address - Phone:212-431-4309
Mailing Address - Fax:212-343-8104
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:SUITE 609
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4408
Practice Address - Country:US
Practice Address - Phone:212-431-4309
Practice Address - Fax:212-343-8104
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23-011313363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY23011313OtherNEW YORK STATE LICENSE
NYMY1482936OtherDEA #