Provider Demographics
NPI:1093076549
Name:CHOE, JUNE (PH D CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:PH D CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 COLONIAL TER
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1622
Mailing Address - Country:US
Mailing Address - Phone:201-838-4587
Mailing Address - Fax:
Practice Address - Street 1:53 COLONIAL TER
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1622
Practice Address - Country:US
Practice Address - Phone:201-838-4587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00379700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist