Healthcare Provider Details
I. General information
NPI: 1619192911
Provider Name (Legal Business Name): JUNE YIJUAN HOU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/13/2007
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1695 EASTCHESTER RD #601
BRONX NY
10461-2374
US
IV. Provider business mailing address
123 YORK ST 16J
NEW HAVEN CT
06511-5614
US
V. Phone/Fax
- Phone: 718-405-8082
- Fax:
- Phone: 508-826-2921
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 243817 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 243817 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: