Provider Demographics
NPI:1780434878
Name:YUN, SEJIN
Entity type:Individual
Prefix:
First Name:SEJIN
Middle Name:
Last Name:YUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 43RD AVE APT 6M
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4927
Mailing Address - Country:US
Mailing Address - Phone:347-416-4218
Mailing Address - Fax:
Practice Address - Street 1:6115 43RD AVE APT 6M
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4927
Practice Address - Country:US
Practice Address - Phone:347-416-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY767040163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health