Provider Demographics
NPI:1124647771
Name:KRA, YAO (RN)
Entity type:Individual
Prefix:
First Name:YAO
Middle Name:
Last Name:KRA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 8TH AVE UNIT 324
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10116-8916
Mailing Address - Country:US
Mailing Address - Phone:646-763-7694
Mailing Address - Fax:
Practice Address - Street 1:222 BLAIR AVE APT 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-3756
Practice Address - Country:US
Practice Address - Phone:646-763-7694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY725114-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse