MEDICARE: KYONG SOON 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	174400000X	Specialist

General Provider Information

NPI Number	:	1669728234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYONG SOON YOON

Provider Business Mailing Address
First Line	:	6744 230TH ST
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2728
Country	:	US
Telephone Number	:	646-704-2603
Fax Number	:

Provider Business Practice Location Address
First Line	:	6744 230TH ST
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2728
Country	:	US
Telephone Number	:	646-704-2603
Fax Number	:

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

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	07/31/2012

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Directions to “ KYONG SOON YOON ” Practice Location

Language	Start Address	Practice Location

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