Provider Demographics
NPI:1902477334
Name:YOO, TAE KYUNG (MD)
Entity Type:Individual
Prefix:
First Name:TAE KYUNG
Middle Name:
Last Name:YOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CONCORD ST
Mailing Address - Street 2:A434(UNION HOUSE)
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8354
Mailing Address - Country:US
Mailing Address - Phone:508-215-7396
Mailing Address - Fax:
Practice Address - Street 1:115 LINCOLN STREET
Practice Address - Street 2:FRAMINGHAM UNION HOSPITAL
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6358
Practice Address - Country:US
Practice Address - Phone:508-215-7396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA288311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine