Provider Demographics
NPI:1396022315
Name:KOO, YUN-BING (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:YUN-BING
Middle Name:
Last Name:KOO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 E BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-1903
Mailing Address - Country:US
Mailing Address - Phone:631-775-9090
Mailing Address - Fax:631-775-9090
Practice Address - Street 1:107 E BARTLETT RD
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-1903
Practice Address - Country:US
Practice Address - Phone:631-775-9090
Practice Address - Fax:631-775-9090
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001038-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist