Provider Demographics
NPI:1477505279
Name:YOON, SERENA H (MD)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:H
Last Name:YOON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:315-476-1792
Practice Address - Street 1:8 BRENTWOOD DR
Practice Address - Street 2:SUITE B
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1863
Practice Address - Country:US
Practice Address - Phone:607-266-7500
Practice Address - Fax:607-257-4318
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-05-14
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Provider Licenses
StateLicense IDTaxonomies
NY199049207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF55211Medicare UPIN
NYRB0512Medicare PIN
NYP00338445Medicare PIN