Provider Demographics
NPI:1386214302
Name:CHO, HYEJIN (PT)
Entity Type:Individual
Prefix:
First Name:HYEJIN
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5118 CODWISE PL
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4149
Mailing Address - Country:US
Mailing Address - Phone:347-242-8513
Mailing Address - Fax:
Practice Address - Street 1:5118 CODWISE PL
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4149
Practice Address - Country:US
Practice Address - Phone:347-242-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist