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Individual
DR. JAE YOON SHIN
Active
Individual
DR. JAE YOON SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00365800
NJ
213E00000X
Podiatrist
N00721001
NY
213E00000X
Podiatrist
POD001311
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
25MD00365800
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00365800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MD00365800
PODIATRIC LICENSE
NJ
01
—
N007210-01
PODIATRIC LICENSE
NY
01
—
POD001311
PODIATRIC LICENSE
GA
Enumeration date
04/03/2013
Last updated
02/01/2022
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