Healthcare Provider Details

I. General information

NPI: 1376280495
Provider Name (Legal Business Name): YENA YOO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 COCOA AVE
HERSHEY PA
17033-1712
US

IV. Provider business mailing address

1120 COCOA AVE
HERSHEY PA
17033-1712
US

V. Phone/Fax

Practice location:
  • Phone: 717-533-4141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS023413
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: