Provider Demographics
NPI:1093203010
Name:B. CHO OPTOMETRY PLLC
Entity Type:Organization
Organization Name:B. CHO OPTOMETRY PLLC
Other - Org Name:BELLPORT PERSPECTIVE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:631-286-4014
Mailing Address - Street 1:5 BELLPORT LN
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2748
Mailing Address - Country:US
Mailing Address - Phone:631-286-4014
Mailing Address - Fax:631-286-2070
Practice Address - Street 1:5 BELLPORT LN
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-2748
Practice Address - Country:US
Practice Address - Phone:631-286-4014
Practice Address - Fax:631-286-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006837152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02716329Medicaid