Healthcare Provider Details

I. General information

NPI: 1568382638
Provider Name (Legal Business Name): THOMAS YOON MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 EASTERN AVE STE 206
DEDHAM MA
02026-4555
US

IV. Provider business mailing address

945 CONCORD ST
FRAMINGHAM MA
01701-4613
US

V. Phone/Fax

Practice location:
  • Phone: 508-578-2720
  • Fax: 508-578-2722
Mailing address:
  • Phone: 508-578-2720
  • Fax: 508-578-2722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: