Provider Demographics
NPI:1417111600
Name:CHO, JOHN SUNGKOOK (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SUNGKOOK
Last Name:CHO
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 1:385 SYLVAN AVE
Mailing Address - Street 2:SUITE 23
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2726
Mailing Address - Country:US
Mailing Address - Phone:201-568-3600
Mailing Address - Fax:201-567-7900
Practice Address - Street 1:385 SYLVAN AVE
Practice Address - Street 2:SUITE 23
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2726
Practice Address - Country:US
Practice Address - Phone:201-568-3600
Practice Address - Fax:201-567-7900
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08408300207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ198469Medicare PIN