Provider Demographics
NPI:1194585448
Name:YI, SANG WON
Entity type:Individual
Prefix:DR
First Name:SANG
Middle Name:WON
Last Name:YI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 W 32ND ST STE 1612
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3874
Mailing Address - Country:US
Mailing Address - Phone:718-497-9760
Mailing Address - Fax:
Practice Address - Street 1:38 W 32ND ST STE 1612
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3874
Practice Address - Country:US
Practice Address - Phone:929-470-4993
Practice Address - Fax:929-415-9189
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013825111NN0400X
NY013825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology