Provider Demographics
NPI:1275190670
Name:YOON, SUNG WOOK
Entity Type:Individual
Prefix:
First Name:SUNG
Middle Name:WOOK
Last Name:YOON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349A SOUNDVIEW LN FL 1
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1167
Mailing Address - Country:US
Mailing Address - Phone:347-401-3886
Mailing Address - Fax:
Practice Address - Street 1:349A SOUNDVIEW LN FL 1
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1167
Practice Address - Country:US
Practice Address - Phone:347-401-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor