Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 052746 | NY |
Y | 1223P0700X | Prosthodontist | DI02215700 | NJ |
NPI | 1023207727 |
---|---|
Provider Name | Dr. Stella Kyung Seok Oh |
First Address | New York, NY 10016-7300 |
Second Address | Oradell, NJ 07649-1525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 18/10/2007 |