Provider Demographics
NPI:1295812378
Name:YOO, DUKE SANG YOUNG III (DPM)
Entity type:Individual
Prefix:DR
First Name:DUKE
Middle Name:SANG YOUNG
Last Name:YOO
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ROBBY LN
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-1072
Mailing Address - Country:US
Mailing Address - Phone:860-874-2351
Mailing Address - Fax:203-787-0004
Practice Address - Street 1:83 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1704
Practice Address - Country:US
Practice Address - Phone:203-787-3800
Practice Address - Fax:203-787-0004
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000745213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BY6681553OtherD.E.A. NUMBER
U95388Medicare UPIN
CT480000938Medicare ID - Type Unspecified