Provider Demographics
NPI:1609847425
Name:RHEE, YOUNG SUN DIANE (MD)
Entity type:Individual
Prefix:
First Name:YOUNG SUN
Middle Name:DIANE
Last Name:RHEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YOUNG SUN
Other - Middle Name:DIANE
Other - Last Name:RHEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:205 ROBIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1424
Mailing Address - Country:US
Mailing Address - Phone:201-599-0026
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA UNIVERSITY DEPATMENT PEDIATRICS
Practice Address - Street 2:3959 BROADWAY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2446
Practice Address - Fax:212-305-4429
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2122072080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02597244Medicaid
NC671Q71Medicaid
NC671Q71Medicaid