Individual
JUNGYOON RO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-7200
(215) 707-3831
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7200
(215) 707-3831
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP014916
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130126
—
PA
Enumeration date
06/17/2015
Last updated
05/01/2018
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