Provider Demographics
NPI:1851337182
Name:CHOI, MISUN (PA)
Entity Type:Individual
Prefix:MS
First Name:MISUN
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56-45 MAIN ST. NEW YORK HOSPITAL QUEENS
Mailing Address - Street 2:ARRHYTHMIA CENTER
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-670-2388
Mailing Address - Fax:
Practice Address - Street 1:56-45 MAIN ST. NEW YORK HOSPITAL QUEENS
Practice Address - Street 2:ARRHYTHMIA CENTER
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6121L1Medicare ID - Type Unspecified
NYG400001925Medicare PIN
NYQ62826Medicare UPIN