Provider Demographics
NPI:1396826970
Name:YOO, EUN S (MD)
Entity Type:Individual
Prefix:DR
First Name:EUN
Middle Name:S
Last Name:YOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 HILLSIDE DR
Mailing Address - Street 2:NEWTON HALL
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9504
Mailing Address - Country:US
Mailing Address - Phone:570-587-7254
Mailing Address - Fax:570-587-7270
Practice Address - Street 1:1451 HILLSIDE DR
Practice Address - Street 2:NEWTON HALL
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-9504
Practice Address - Country:US
Practice Address - Phone:570-587-7254
Practice Address - Fax:570-587-7270
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036883L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
187102GRGMedicare ID - Type UnspecifiedMEDICARE ID NUMBER