Provider Demographics
NPI:1417318189
Name:CHOI, WOOJEONG
Entity Type:Individual
Prefix:
First Name:WOOJEONG
Middle Name:
Last Name:CHOI
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 1:601 W 110TH ST
Mailing Address - Street 2:#3K5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2186
Mailing Address - Country:US
Mailing Address - Phone:917-900-2052
Mailing Address - Fax:
Practice Address - Street 1:601 W 110TH ST
Practice Address - Street 2:#3K5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2186
Practice Address - Country:US
Practice Address - Phone:917-900-2052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist