Provider Demographics
NPI:1881456028
Name:THOMAS YOUM MD LLC
Entity type:Organization
Organization Name:THOMAS YOUM MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-348-3636
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14851-0056
Mailing Address - Country:US
Mailing Address - Phone:212-348-3636
Mailing Address - Fax:
Practice Address - Street 1:34 S DEAN ST STE 202
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3515
Practice Address - Country:US
Practice Address - Phone:212-348-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty