Provider Demographics
NPI:1760722946
Name:YOON, DOOSIK (DPT)
Entity Type:Individual
Prefix:
First Name:DOOSIK
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 UNION ST STE 204
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5588
Mailing Address - Country:US
Mailing Address - Phone:347-705-3252
Mailing Address - Fax:
Practice Address - Street 1:3819 UNION ST STE 204
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5588
Practice Address - Country:US
Practice Address - Phone:347-705-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030025225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist