Basic Information
Provider Information
NPI: 1104358191
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWNING
FirstName: CAROLINE
MiddleName: YOON
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: YOON
OtherFirstName: CAROLINE
OtherMiddleName: EUNHAE
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Practice Location
Address1: 130 S BRYN MAWR AVE
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103121
CountryCode: US
TelephoneNumber: 4843373000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/30/2017
LastUpdateDate: 05/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XOS020552PAN Allopathic & Osteopathic PhysiciansPediatrics 
207PP0204XOS020552PAY Allopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine

No ID Information.


Home