Provider Demographics
NPI:1205912540
Name:YUM, SABRINA S (MD)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:S
Last Name:YUM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9258
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA - NEUROLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1719
Practice Address - Fax:215-590-1771
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2015-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD059357L174400000X, 2084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No174400000XOther Service ProvidersSpecialist
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016147000005Medicaid
PA0016147000005Medicaid