Provider Demographics
NPI:1033109376
Name:YOUN, JUNG H (MD)
Entity Type:Individual
Prefix:
First Name:JUNG
Middle Name:H
Last Name:YOUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FRANKLIN AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2926
Mailing Address - Country:US
Mailing Address - Phone:516-248-6868
Mailing Address - Fax:516-248-6841
Practice Address - Street 1:1000 FRANKLIN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2926
Practice Address - Country:US
Practice Address - Phone:516-248-6868
Practice Address - Fax:516-248-6841
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1917201207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01696088Medicaid
53J801Medicare ID - Type Unspecified
NY01696088Medicaid