Provider Demographics
NPI:1114238623
Name:CHO, YOUNGRAN
Entity Type:Individual
Prefix:
First Name:YOUNGRAN
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 CLINTONVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1228
Mailing Address - Country:US
Mailing Address - Phone:718-878-4052
Mailing Address - Fax:
Practice Address - Street 1:716 CLINTONVILLE ST
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1228
Practice Address - Country:US
Practice Address - Phone:718-878-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5121891163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool