Individual
JAE EUN YOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 606-1172
Mailing address
PO BOX 29234, NEW YORK, NY 10087-9234
(212) 606-1172
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
430550
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2010009411
ANCC
—
01
—
F430550
NY EDUCATION DEPARTMENT
NY
Enumeration date
07/20/2011
Last updated
04/13/2021
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