Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 25MA05360700 | NJ |
NPI | 1003833682 |
---|---|
Provider Name | Dr. Sung Koo Yun |
First Address | Englewood Cliffs, NJ 07632-2917 |
Second Address | Englewood Cliffs, NJ 07632-2917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 25/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1303201 | (05) | NJ |
F05902 | (02) |