Provider Demographics
NPI:1821370230
Name:BYUN, YOONG KOO
Entity Type:Individual
Prefix:MR
First Name:YOONG
Middle Name:KOO
Last Name:BYUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-6223
Mailing Address - Country:US
Mailing Address - Phone:781-324-4745
Mailing Address - Fax:781-324-7957
Practice Address - Street 1:215 BEACH ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-6223
Practice Address - Country:US
Practice Address - Phone:781-324-4745
Practice Address - Fax:781-324-7957
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH25371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist