Seoyeon Yoo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045904 Issued in NY

Practice address

55 Jericho Tpke Ste 102
Jericho, NY 11753-1013

Phone

(516) 506-7888

Fax

(516) 833-6044

NPI assigned

Sep 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1861008591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W 34TH ST RM 402B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 JERICHO TPKE STE 102",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531013",
            "telephone_number": "516-506-7888",
            "fax_number": "516-833-6044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 W 34th St Rm 402B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100013011",
            "country_code": "US",
            "telephone_number": "332-207-0610",
            "fax_number": "347-824-2017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOO",
        "first_name": "SEOYEON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Jericho, NY
• Providers in Jericho, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.