Provider Demographics
NPI:1942242490
Name:CHO, JOAN OKKYUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:OKKYUNG
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 208237
Mailing Address - Street 2:55 LOCK STREET
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8237
Mailing Address - Country:US
Mailing Address - Phone:203-432-0076
Mailing Address - Fax:203-432-0075
Practice Address - Street 1:55 LOCK STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520-8237
Practice Address - Country:US
Practice Address - Phone:203-432-0076
Practice Address - Fax:203-432-0075
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2011-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT027052207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38706Medicare UPIN