Provider Demographics
NPI:1245279348
Name:CHOI, JEA KEUN (MD)
Entity type:Individual
Prefix:DR
First Name:JEA
Middle Name:KEUN
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 NEWARK AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1326
Mailing Address - Country:US
Mailing Address - Phone:201-222-8288
Mailing Address - Fax:201-222-8265
Practice Address - Street 1:550 NEWARK AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1326
Practice Address - Country:US
Practice Address - Phone:201-222-8288
Practice Address - Fax:201-222-8265
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA56694207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1094921OtherUNITED HEALTHCARE
1453618-001OtherCIGNA HMO
818180OtherCOMED HMO
HP063OtherOXFORD
NJ5173809Medicaid
4121011OtherCIGNA
140137OtherUS HEALTHCARE
2501688OtherGHI
10G451OtherEMPIRE BCBS
4226989OtherAETNA
NJF02151Medicare UPIN
NJ5173809Medicaid