Provider Demographics
NPI:1699952903
Name:KAIYUNG WOO, MD PC
Entity type:Organization
Organization Name:KAIYUNG WOO, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAIYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-463-5107
Mailing Address - Street 1:150 HUNT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-1834
Mailing Address - Country:US
Mailing Address - Phone:315-463-5107
Mailing Address - Fax:315-463-6029
Practice Address - Street 1:321 GENESEE ST
Practice Address - Street 2:ONEIDA HEALTHCARE CENTER
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2611
Practice Address - Country:US
Practice Address - Phone:315-463-5107
Practice Address - Fax:315-463-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193489-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBW4429165OtherDEA
NYG38121Medicare UPIN