Provider Demographics
NPI:1598809147
Name:CHO, HENRY HEECHANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:HEECHANG
Last Name:CHO
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:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-0130
Mailing Address - Country:US
Mailing Address - Phone:703-887-1541
Mailing Address - Fax:
Practice Address - Street 1:270 CONCORD ST
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-1318
Practice Address - Country:US
Practice Address - Phone:703-887-1541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212253207Q00000X
NJ25MA08710900207Q00000X
VA0101657892207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH37027Medicare UPIN