Provider Demographics
NPI:1427301902
Name:JEONG, YUNKYOUNG (NP)
Entity type:Individual
Prefix:MRS
First Name:YUNKYOUNG
Middle Name:
Last Name:JEONG
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 HERRICKS RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3724
Mailing Address - Country:US
Mailing Address - Phone:347-368-6691
Mailing Address - Fax:
Practice Address - Street 1:3819 UNION ST STE 204
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5588
Practice Address - Country:US
Practice Address - Phone:347-368-6691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-20
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7973933364SA2200X
NYF306229363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health