Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 117518-1 | NY |
NPI | 1235187410 |
---|---|
Provider Name | Dr. Young Sook Hong |
First Address | Troy, NY 12180-1600 |
Second Address | Troy, NY 12180-1600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00542296 | (05) | NY |
C49881 | (02) | NY |