Most Relevant Information
Provider Data
| NPI Number: | 1003371766 |
| Provider Name: | KELLY JEE YOON WON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/07/2019 |
| Last Updated: | 10/04/2019 |
Provider Practice Location
8403 57TH AVE
ELMHURST
NY
113734833
Practice Location Phone/Fax
| Phone: | 7188999060 |
| Fax: | 7188999061 |
Provider Mailing Location
14648 23RD AVE
WHITESTONE
NY
113573514
Provider Mailing Phone/Fax
| Phone: | 7187994145 |
| Fax: |