Provider Demographics
NPI:1184697526
Name:CHOI, PAUL S (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 E 72ND ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4028
Mailing Address - Country:US
Mailing Address - Phone:212-288-1575
Mailing Address - Fax:212-288-7616
Practice Address - Street 1:519 E 72ND ST
Practice Address - Street 2:SUITE 103
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4028
Practice Address - Country:US
Practice Address - Phone:212-288-1575
Practice Address - Fax:212-288-7616
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220898-12085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI26882Medicare UPIN
NY747S11Medicare ID - Type Unspecified