Provider Demographics
NPI:1568882124
Name:CHOI, SOON OK
Entity Type:Individual
Prefix:
First Name:SOON OK
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 1:326 BRIDGE PLZ N
Mailing Address - Street 2:APT # 2J
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5017
Mailing Address - Country:US
Mailing Address - Phone:210-870-5865
Mailing Address - Fax:
Practice Address - Street 1:326 BRIDGE PLZ N
Practice Address - Street 2:APT # 2J
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5017
Practice Address - Country:US
Practice Address - Phone:210-870-5865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY547770163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool