Provider Demographics
NPI:1659398238
Name:YOUNER, JOHANNA (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:
Last Name:YOUNER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PARK AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3456
Mailing Address - Country:US
Mailing Address - Phone:212-683-7757
Mailing Address - Fax:212-889-6150
Practice Address - Street 1:40 PARK AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3456
Practice Address - Country:US
Practice Address - Phone:212-683-7757
Practice Address - Fax:212-889-6150
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004943213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0128Medicaid
NY1659398238OtherNPI
U54477Medicare UPIN
P53171Medicare ID - Type Unspecified
NY4695560001Medicare NSC