Provider Demographics
NPI:1811482094
Name:YOUV, ANDREW SO (AGACNP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SO
Last Name:YOUV
Suffix:
Gender:M
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 4TH AVE APT D6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3720
Mailing Address - Country:US
Mailing Address - Phone:210-887-2782
Mailing Address - Fax:
Practice Address - Street 1:94 BOWERY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4888
Practice Address - Country:US
Practice Address - Phone:212-335-0328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431393363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care