Provider Demographics
NPI:1497072656
Name:CHO, KEVIN J (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:CHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 442
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-0442
Mailing Address - Country:US
Mailing Address - Phone:646-706-1975
Mailing Address - Fax:718-638-8257
Practice Address - Street 1:236 7TH AVE
Practice Address - Street 2:SUITE#5E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3481
Practice Address - Country:US
Practice Address - Phone:646-706-1975
Practice Address - Fax:718-638-8257
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255958-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery