Provider Demographics
NPI:1659717585
Name:FLAKES, SOOHYUNG K
Entity Type:Individual
Prefix:
First Name:SOOHYUNG
Middle Name:K
Last Name:FLAKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOOYUNG
Other - Middle Name:
Other - Last Name:FLAKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:450 W 42ND ST
Mailing Address - Street 2:APARTMENT 21A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-6800
Mailing Address - Country:US
Mailing Address - Phone:267-994-9674
Mailing Address - Fax:
Practice Address - Street 1:450 W 42ND ST
Practice Address - Street 2:APARTMENT 21A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6800
Practice Address - Country:US
Practice Address - Phone:267-994-9674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program