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General NPI Number Information
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NPI Number | 1477075448
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Entity Type | Organization
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Legal Business Name | SORA YOON MD LLC
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/12/2017
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Provider Practice Location Address
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Address Line | 1051 W SHERMAN AVE BLDG 2
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City | VINELAND
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State | NJ
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Zip | 08360-6931
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Country | US
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Telephone | 856-451-9395
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | BRIDGETON
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State | NJ
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Zip | 08302-0109
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Country | US
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Telephone | 856-451-9395
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Fax | 856-451-8615
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Authorized Official
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Title or Position | CREDENTIALING & BILLING MANAGER
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Name | BETTY GANDY
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Credential |
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Telephone | 856-451-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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