Provider Demographics
NPI:1679799274
Name:CHO, WOOCHAN (RPT, MS)
Entity type:Individual
Prefix:
First Name:WOOCHAN
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:RPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3626
Mailing Address - Country:US
Mailing Address - Phone:917-834-0044
Mailing Address - Fax:
Practice Address - Street 1:271 MADISON AVE
Practice Address - Street 2:SUITE 1601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1001
Practice Address - Country:US
Practice Address - Phone:212-682-2750
Practice Address - Fax:212-682-6588
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist