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General NPI Number Information
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NPI Number | 1770391567
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Entity Type | Organization
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Legal Business Name | YONSEI PMC PAIN MANAGEMENT P C
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Dates
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Enumeration Date | 12/25/2024
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Last Update Date | 12/25/2024
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Provider Practice Location Address
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Address Line | 232 BROAD AVE STE 206
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1565
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Country | US
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Telephone | 201-710-7986
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Fax | 201-710-7599
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Provider Business Mailing Address
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Address Line | 232 BROAD AVE STE 206
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1565
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Country | US
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Telephone | 201-710-7986
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Fax | 201-710-7599
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON YOO
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Credential | MD
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Telephone | 201-710-7986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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