Provider Demographics
NPI:1689055139
Name:CHOE, JOON WEON
Entity Type:Individual
Prefix:
First Name:JOON WEON
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4295 ARTHUR KILL RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1343
Mailing Address - Country:US
Mailing Address - Phone:718-227-8266
Mailing Address - Fax:718-227-8268
Practice Address - Street 1:4295 ARTHUR KILL RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1343
Practice Address - Country:US
Practice Address - Phone:718-227-8266
Practice Address - Fax:718-227-8268
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care