Provider Demographics
NPI:1639712250
Name:YUN, FABIOLA (DNP)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:YUN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:FABIOLA
Other - Middle Name:
Other - Last Name:YUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:177 LIVINGSTON ST UNIT LL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-7000
Mailing Address - Country:US
Mailing Address - Phone:212-356-1204
Mailing Address - Fax:
Practice Address - Street 1:177 LIVINGSTON ST UNIT LL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-7000
Practice Address - Country:US
Practice Address - Phone:212-356-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403507363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health