Provider Demographics
NPI:1720345424
Name:CHO, YOON-JUNG DIANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:YOON-JUNG
Middle Name:DIANNA
Last Name:CHO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DIANNA
Other - Middle Name:
Other - Last Name:CHO-LYON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:7811 GAYLE RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1005
Mailing Address - Country:US
Mailing Address - Phone:404-435-3452
Mailing Address - Fax:
Practice Address - Street 1:7811 GAYLE RD
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1005
Practice Address - Country:US
Practice Address - Phone:404-435-3452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist