Provider Demographics
NPI:1497033120
Name:CHO, KI-YOUNG
Entity Type:Individual
Prefix:MR
First Name:KI-YOUNG
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272A HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-2464
Mailing Address - Country:US
Mailing Address - Phone:240-461-3450
Mailing Address - Fax:
Practice Address - Street 1:272A HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-2464
Practice Address - Country:US
Practice Address - Phone:240-461-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist