Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 190220 | NY |
NPI | 1255472015 |
---|---|
Provider Name | Dr. Ki Yoo |
First Address | Flushing, NY 11355-2205 |
Second Address | Flushing, NY 11355-2205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G22347 | (02) | NY |