Provider Demographics
NPI:1326571399
Name:YOO, ANDREA SUJUNG (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUJUNG
Last Name:YOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SU JUNG
Other - Middle Name:
Other - Last Name:YOO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:428 E 72ND ST OFC 400
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4635
Mailing Address - Country:US
Mailing Address - Phone:212-746-2584
Mailing Address - Fax:
Practice Address - Street 1:428 E 72ND ST OFC 400
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4635
Practice Address - Country:US
Practice Address - Phone:212-746-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2023-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3105392084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology