Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 196329 | NY |
NPI | 1073550232 |
---|---|
Provider Name | Jaime Yun |
First Address | Philadelphia, PA 19195-2424 |
Second Address | New York, NY 10003-3314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 28/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02724385 | (05) | NY |
H47760 | (02) | NY |