Provider Demographics
NPI:1194281915
Name:YOO, YOUNG WOOK (ACUPUNCTURIST)
Entity type:Individual
Prefix:MR
First Name:YOUNG WOOK
Middle Name:
Last Name:YOO
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-1730
Mailing Address - Country:US
Mailing Address - Phone:201-638-8777
Mailing Address - Fax:
Practice Address - Street 1:88 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:DEMAREST
Practice Address - State:NJ
Practice Address - Zip Code:07627-1730
Practice Address - Country:US
Practice Address - Phone:201-638-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006480-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist