Provider Demographics
NPI:1972123149
Name:FARAH-PETERSON, YUNA (DPM)
Entity Type:Individual
Prefix:
First Name:YUNA
Middle Name:
Last Name:FARAH-PETERSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:YUNA
Other - Middle Name:FARAH
Other - Last Name:MINOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2520 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-2092
Mailing Address - Country:US
Mailing Address - Phone:304-675-4340
Mailing Address - Fax:
Practice Address - Street 1:2416 JEFFERSON AVE STE B
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-1528
Practice Address - Country:US
Practice Address - Phone:304-675-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV10500213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program