Provider Demographics
NPI:1821037961
Name:SHIN, JOOYOUNG JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOOYOUNG
Middle Name:JULIA
Last Name:SHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOOYOUNG
Other - Middle Name:JULIA
Other - Last Name:SHIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:140 RIVERSIDE BLVD
Mailing Address - Street 2:APT 505
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0601
Mailing Address - Country:US
Mailing Address - Phone:212-799-3143
Mailing Address - Fax:
Practice Address - Street 1:3400 BAINBRIDGE AVENUE
Practice Address - Street 2:CENTER FOR ADVANCED CARDIAC THERAPY, MAP 7
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-2248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051549207R00000X
NY241126207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine