MEDICARE: DR. HANA YOON

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	122300000X	Dentist	061233	NY

General Provider Information

NPI Number	:	1619532223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANA YOON

Provider Business Mailing Address
First Line	:	301 W 53RD ST APT 5G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-5768
Country	:	US
Telephone Number	:	515-450-9911
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 MAIN ST STE 411
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5483
Country	:	US
Telephone Number	:	718-353-4908
Fax Number	:

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

Provider Enumeration Date	:	05/08/2019
Last Update Date	:	10/15/2020

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Directions to “ DR. HANA YOON ” Practice Location

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