Basic Information
| Provider Information | |||||||||
| NPI: | 1073897351 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOO | ||||||||
| FirstName: | SINAE | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1220 CHESTER PIKE | ||||||||
| Address2: | |||||||||
| City: | SHARON HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190791902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105862122 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1220 CHESTER PIKE | ||||||||
| Address2: | |||||||||
| City: | SHARON HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190791902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105862122 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2011 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AC000910 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | SP014112 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.