Provider Demographics
NPI:1619204112
Name:CHO, JENNIFER H (OD, FAAO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:H
Last Name:CHO
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GRANITE POINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1992
Mailing Address - Country:US
Mailing Address - Phone:610-378-1344
Mailing Address - Fax:610-378-5169
Practice Address - Street 1:1 GRANITE POINT DR STE 100
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1992
Practice Address - Country:US
Practice Address - Phone:610-378-1344
Practice Address - Fax:610-378-5169
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002213152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025243700001Medicaid
PA10252437Medicaid