MEDICARE: MR. ZACHARY YUN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	018970-1	NY

General Provider Information

NPI Number	:	1356310254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ZACHARY YUN PT

Provider Business Mailing Address
First Line	:	274 W 145TH ST
Second Line	:	SUITE 310
City	:	NEW YORK
State	:	NY
Zip	:	10039-4122
Country	:	US
Telephone Number	:	212-368-7800
Fax Number	:	212-368-7803

Provider Business Practice Location Address
First Line	:	274 W 145TH ST
Second Line	:	SUITE 310
City	:	NEW YORK
State	:	NY
Zip	:	10039-4122
Country	:	US
Telephone Number	:	732-763-8112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	01/07/2014

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