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General NPI Number Information
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NPI Number | 1083805154
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Entity Type | Organization
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Legal Business Name | OO HYON KYONG, MD
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 1290 TRUMANSBURG RD
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City | ITHACA
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State | NY
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Zip | 14850-1314
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Country | US
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Telephone | 607-273-4331
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Fax | 607-272-0257
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Provider Business Mailing Address
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Address Line | 1290 TRUMANSBURG RD
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City | ITHACA
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State | NY
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Zip | 14850-1314
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Country | US
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Telephone | 607-273-4331
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Fax | 607-272-0257
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Authorized Official
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Title or Position | OWNER
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Name | DR. OO HYON KYONG
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Credential | MD
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Telephone | 607-273-4331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 122217
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License Number State | NY
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