Healthcare Provider Details

I. General information

NPI: 1518885516
Provider Name (Legal Business Name): CHAERI RYU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

14245 58TH RD
FLUSHING NY
11355-5310
US

IV. Provider business mailing address

2632 ATLANTIC AVE
BROOKLYN NY
11207-2425
US

V. Phone/Fax

Practice location:
  • Phone: 718-445-4222
  • Fax:
Mailing address:
  • Phone: 718-473-3808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: