Provider Demographics
NPI:1275695595
Name:CHOE, ERIC IN (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:IN
Last Name:CHOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E 60TH ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1117
Mailing Address - Country:US
Mailing Address - Phone:212-838-1212
Mailing Address - Fax:212-838-1712
Practice Address - Street 1:121 E 60TH ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1117
Practice Address - Country:US
Practice Address - Phone:212-838-1212
Practice Address - Fax:212-838-1712
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180934-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01393071Medicaid
NYF40497Medicare UPIN
NYF40497Medicare UPIN
NY03601Medicare ID - Type Unspecified