Provider Demographics
NPI:1952409237
Name:CHO, DAMIEN SEUNG C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAMIEN
Middle Name:SEUNG C
Last Name:CHO
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 1:620 CRANBURY RD
Mailing Address - Street 2:SUITE LL 90
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4098
Mailing Address - Country:US
Mailing Address - Phone:732-967-0033
Mailing Address - Fax:732-967-0055
Practice Address - Street 1:812 COURTYARD DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4258
Practice Address - Country:US
Practice Address - Phone:908-725-2510
Practice Address - Fax:908-725-2132
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02613900174400000X
NJ25MA26139174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2162202Medicaid
NJ456635Medicare ID - Type Unspecified
NJ2162202Medicaid