Provider Demographics
NPI:1518075233
Name:CHOE, DAI SUN (MD)
Entity Type:Individual
Prefix:
First Name:DAI SUN
Middle Name:
Last Name:CHOE
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 1:7501 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3201
Mailing Address - Country:US
Mailing Address - Phone:718-238-6116
Mailing Address - Fax:718-238-6590
Practice Address - Street 1:7501 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3201
Practice Address - Country:US
Practice Address - Phone:718-238-6116
Practice Address - Fax:718-238-6590
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113346208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00205674Medicaid
NY00205674Medicaid
653791Medicare ID - Type Unspecified