Provider Demographics
NPI:1134147473
Name:YANG, SUNG HOON (MD)
Entity type:Individual
Prefix:
First Name:SUNG HOON
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6251 COUNTY ROUTE 64
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-9277
Mailing Address - Country:US
Mailing Address - Phone:607-324-1615
Mailing Address - Fax:607-324-6380
Practice Address - Street 1:6251 COUNTY ROUTE 64
Practice Address - Street 2:SUITE 101
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-9277
Practice Address - Country:US
Practice Address - Phone:607-324-1615
Practice Address - Fax:607-324-6380
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128818207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLICENSE NO. 128818OtherPHYSICIAN
NY485929 2Medicaid
D02167Medicare UPIN
NY485929 2Medicaid