MEDICARE: GIHEE YOON

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	:	1831591155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIHEE YOON

Provider Business Mailing Address
First Line	:	169 S MAIN ST
Second Line	:	#344
City	:	NEW CITY
State	:	NY
Zip	:	10956-3353
Country	:	US
Telephone Number	:	646-450-8455
Fax Number	:	646-570-1986

Provider Business Practice Location Address
First Line	:	230 W 125TH ST
Second Line	:	#1
City	:	NEW YORK
State	:	NY
Zip	:	10027-4402
Country	:	US
Telephone Number	:	646-450-8455
Fax Number	:	646-570-1986

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

Provider Enumeration Date	:	09/17/2014
Last Update Date	:	02/12/2015

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Directions to “ GIHEE YOON ” Practice Location

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