Provider Demographics
NPI:1013026665
Name:YOON, JULIE E (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:YOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 WHITE SPRUCE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1606
Mailing Address - Country:US
Mailing Address - Phone:585-424-7032
Mailing Address - Fax:585-427-2712
Practice Address - Street 1:300 WHITE SPRUCE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1606
Practice Address - Country:US
Practice Address - Phone:585-424-7032
Practice Address - Fax:585-427-2712
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242906208M00000X
NY242906-1207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013026665OtherNPI
11924864OtherCAQH
1013026665OtherNPI
NYJ400001335OtherMEDICARE PTAN