MEDICARE: HENRY YOON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	038953	CT

General Provider Information

NPI Number	:	1790786259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY YOON M.D.

Provider Business Mailing Address
First Line	:	1 HOSPITAL PLZ
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-3602
Country	:	US
Telephone Number	:	203-276-2270
Fax Number	:	203-276-2413

Provider Business Practice Location Address
First Line	:	1 HOSPITAL PLZ
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-3602
Country	:	US
Telephone Number	:	203-276-2270
Fax Number	:	203-276-2413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	04/16/2024

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