Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 060235 | NY |
N | 1223G0001X | General Practice | 11636 | CT |
N | 213EG0000X | General Practice | 11636 | CT |
NPI | 1700298676 |
---|---|
Provider Name | Dr. Jihee Woo |
First Address | New York, NY 10021-4751 |
Second Address | Hampton, VA 23666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 20/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060235 | DENTAL LICENSE (01) | NY |