Provider Demographics
NPI:1619188943
Name:SUNG, JOO-YEON (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOO-YEON
Middle Name:
Last Name:SUNG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:JOANNE
Other - Middle Name:JOO-YEON
Other - Last Name:SUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:12467 CEDAR RD
Mailing Address - Street 2:5A
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3270
Mailing Address - Country:US
Mailing Address - Phone:212-677-7814
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:DEPARTMENT OF DERMATOLOGY
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:212-677-7814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.012196207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology