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Individual
SAMUEL SANGWON YOO
Active
Individual
SAMUEL SANGWON YOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
025179
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891939625
—
NY
01
—
A400026932
MEDICARE MEMBER PTAN FOR BROOKLYN, STATEN ISLAND, MANHATTAN
NY
01
—
G400061606
MEDICARE MEMBER PTAN FOR QUEENS
NY
Enumeration date
04/23/2009
Last updated
02/21/2022
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