Provider Demographics
NPI:1396256103
Name:KOSKEY, YOUNG DUK (FNP-BC)
Entity type:Individual
Prefix:
First Name:YOUNG DUK
Middle Name:
Last Name:KOSKEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:YOUNG
Other - Middle Name:DUK
Other - Last Name:KOSKEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:YOUNG KOSKEY FNP-BC
Mailing Address - Street 1:75 BROAD ST RM 815
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-3233
Mailing Address - Country:US
Mailing Address - Phone:347-761-3168
Mailing Address - Fax:
Practice Address - Street 1:75 BROAD ST RM 815
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-3233
Practice Address - Country:US
Practice Address - Phone:347-761-3168
Practice Address - Fax:929-285-9069
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily