Provider Demographics
NPI:1437852134
Name:RHEE, YONG SHU
Entity Type:Individual
Prefix:
First Name:YONG SHU
Middle Name:
Last Name:RHEE
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 1:410 23RD ST
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-2128
Mailing Address - Country:US
Mailing Address - Phone:714-335-0145
Mailing Address - Fax:
Practice Address - Street 1:410 23RD ST
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-2128
Practice Address - Country:US
Practice Address - Phone:714-335-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care