MEDICARE: YOONJUNG NOH

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1811449648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOONJUNG NOH

Provider Business Mailing Address
First Line	:	4549 40TH ST APT 1R
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11104-3921
Country	:	US
Telephone Number	:	646-703-2550
Fax Number	:

Provider Business Practice Location Address
First Line	:	4549 40TH ST APT 1R
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11104-3921
Country	:	US
Telephone Number	:	646-703-2550
Fax Number	:

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

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	10/27/2016

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Directions to “ YOONJUNG NOH ” Practice Location

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