Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | F431136 | NY |
NPI | 1003325564 |
---|---|
Provider Name | Yuson Chong |
First Address | Manhasset, NY 11030-3816 |
Second Address | Manhasset, NY 11030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2017 |
Last Update Date | 13/06/2018 |