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General NPI Number Information
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NPI Number | 1447590773
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Entity Type | Individual
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Provider Name | JOON-YONG KOH
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Gender | Male
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Dates
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Enumeration Date | 02/23/2013
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 1733 ULSTER AVE
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City | LAKE KATRINE
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State | NY
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Zip | 12449-5426
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Country | US
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Telephone | 412-818-4975
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Fax |
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Provider Business Mailing Address
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Address Line | 1733 ULSTER AVE
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City | LAKE KATRINE
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State | NY
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Zip | 12449-5426
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Country | US
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Telephone | 845-512-1230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 059553-1
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License Number State | NY
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