Provider Demographics
NPI:1528592458
Name:CHOU, KATHY (DO)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:CHOU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BERGEN STREET
Mailing Address - Street 2:DOCTORS OFFICE CENTER- SUITE 3300
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103
Mailing Address - Country:US
Mailing Address - Phone:972-972-2800
Mailing Address - Fax:
Practice Address - Street 1:90 BERGEN STREET
Practice Address - Street 2:DOCTORS OFFICE CENTER- SUITE 3300
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-972-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315376208100000X
NJ25MB11952600208VP0014X, 208100000X
MI5101026077208VP0014X
MIAU7007467-024985208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine