Basic Information
Provider Information
NPI: 1245691286
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOON
FirstName: JUNSIK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214898
CountryCode: US
TelephoneNumber: 2126061000
FaxNumber:  
Practice Location
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214898
CountryCode: US
TelephoneNumber: 2126061000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/18/2016
LastUpdateDate: 09/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT293258CAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X25854MDN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X044467NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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