Provider Demographics
NPI:1003872557
Name:LJUNG, YNGE (AP)
Entity Type:Individual
Prefix:
First Name:YNGE
Middle Name:
Last Name:LJUNG
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 NE 45TH ST
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5199
Mailing Address - Country:US
Mailing Address - Phone:954-667-6637
Mailing Address - Fax:954-667-6629
Practice Address - Street 1:1915 NE 45TH ST
Practice Address - Street 2:SUITE # 202
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5199
Practice Address - Country:US
Practice Address - Phone:954-667-6637
Practice Address - Fax:954-667-6629
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL650171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist