Provider Demographics
NPI:1902182397
Name:SCARSDALE INTEGRATIVE FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:SCARSDALE INTEGRATIVE FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HYUN JOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-722-9440
Mailing Address - Street 1:2 OVERHILL RD STE 260
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5334
Mailing Address - Country:US
Mailing Address - Phone:914-722-9440
Mailing Address - Fax:914-722-9441
Practice Address - Street 1:2 OVERHILL RD STE 260
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5334
Practice Address - Country:US
Practice Address - Phone:914-722-9440
Practice Address - Fax:914-722-9441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-29
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty