Provider Demographics
NPI:1396036448
Name:YANG, SEUNG-YUN
Entity Type:Individual
Prefix:
First Name:SEUNG-YUN
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W 24TH ST
Mailing Address - Street 2:APT 7B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1909
Mailing Address - Country:US
Mailing Address - Phone:562-760-6538
Mailing Address - Fax:
Practice Address - Street 1:101 W 24TH ST
Practice Address - Street 2:APT 7B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1909
Practice Address - Country:US
Practice Address - Phone:562-760-6538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021374-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist