Active NPIIndividual provider

Soo H Ko, AGNP

Nurse Practitioner, Gerontology in East Boston, Massachusetts

NPI Number1114673092
Practice location
10 Gove St, East Boston, MA 02128-1931
Fax
—
Last updated
January 19, 2024

Soo H Ko is a Nurse Practitioner, Gerontology based in East Boston, MA. Soo H Ko practices in East Boston, MA and has the professional credentials of AGNP. The NPI Number for Soo H Ko is 1114673092 and holds a License No. RN2326883 (MA). The current practice location address for Soo H Ko is 10 Gove St, East Boston, MA 02128-1931 and can be reached out via phone at 617-569-5899.

Provider Profile Details

NPI Number
1114673092
Provider Name
Soo H Ko
Credential
AGNP
Provider Entity Type
Individual
Gender
Female
Address
10 Gove St, East Boston, MA 02128-1931
Phone Number
617-569-5899
Primary Taxonomy
Nurse Practitioner, Gerontology · 363LG0600X
Sole Proprietor
No
Provider Enumeration Date
March 1, 2022
Last Update Date
January 19, 2024
Certification Date
January 19, 2024
NPI Status
Active

Provider Business Practice Location Address Details

Address
10 Gove St
East Boston, MA 02128-1931
Zip
02128-1931
Phone Number
617-569-5899
East Boston, MA 02128Get directions →

Provider Business Mailing Address Details

Address
10 Gove St
East Boston, MA 02128-1931
City
East Boston
State
MA
Zip
02128-1931
Phone Number
617-569-5899

License Information

License Number (1)
RN2326883
License State (1)
MA
Taxonomy (1)
Registered Nurse · 163W00000X
License Number (2)
RN2326883
License State (2)
MA
Taxonomy (2)
Nurse Practitioner, Gerontology · 363LG0600X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Soo H Ko, AGNP?

The NPI number of Soo H Ko, AGNP is 1114673092. It was assigned on March 1, 2022 and is currently active in the NPPES registry.

What is the specialty of Soo H Ko, AGNP?

Soo H Ko, AGNP is registered under the primary taxonomy Nurse Practitioner, Gerontology (code 363LG0600X), licensed in MA under license number RN2326883.

Where does Soo H Ko, AGNP practice?

The practice location is 10 Gove St, East Boston, MA 02128-1931. The office can be reached at 617-569-5899 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1114673092 directly on the NPPES registry website.

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