Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA00915100 | NJ |
NPI | 1144617432 |
---|---|
Provider Name | Jennifer Yoo |
First Address | Montvale, NJ 07645-2107 |
Second Address | Montvale, NJ 07645-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 24/04/2015 |