Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 050976 | NY |
NPI | 1760486377 |
---|---|
Provider Name | Dr. Angela Jiyeon Yoon |
First Address | Clifton, NJ 07013-1604 |
Second Address | New York, NY 10032-3702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 08/07/2007 |