Provider Demographics
NPI:1780907287
Name:SUN, YUHWA
Entity type:Individual
Prefix:
First Name:YUHWA
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CARY RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1517
Mailing Address - Country:US
Mailing Address - Phone:516-487-5729
Mailing Address - Fax:718-461-8373
Practice Address - Street 1:25 CARY RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1517
Practice Address - Country:US
Practice Address - Phone:516-487-5729
Practice Address - Fax:718-461-8373
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030340183500000X, 1835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support