Individual provider Active NPI

Yun-Bing Koo, O.T.R./L

  • Occupational Therapist
  • Middle Island, NY
National Provider Identifier
1396022315
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
001038-1 Issued in NY
Practice address
107 E Bartlett Rd
Middle Island, NY 11953-1903
Phone
(631) 775-9090
Fax
(631) 775-9090
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 001038-1 NY Primary

Addresses

Primary practice location

107 E Bartlett Rd
Middle Island, NY 11953-1903

Mailing address

107 E Bartlett Rd
Middle Island, NY 11953-1903
Phone (631) 775-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001038-1NYMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1396022315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E BARTLETT RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119531903",
            "telephone_number": "631-775-9090",
            "fax_number": "631-775-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E BARTLETT RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119531903",
            "telephone_number": "631-775-9090",
            "fax_number": "631-775-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "YUN-BING",
        "name_prefix": "Mrs.",
        "credential": "O.T.R./L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "001038-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.