Provider Demographics
NPI:1679234702
Name:YUN JAE CHO MEDICAL PC
Entity Type:Organization
Organization Name:YUN JAE CHO MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YUN
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:585-975-9756
Mailing Address - Street 1:3830 PARSONS BLVD STE 1D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5841
Mailing Address - Country:US
Mailing Address - Phone:585-975-9756
Mailing Address - Fax:
Practice Address - Street 1:3830 PARSONS BLVD STE 1D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5841
Practice Address - Country:US
Practice Address - Phone:187-621-7107
Practice Address - Fax:718-762-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center