Provider Demographics
NPI:1952747040
Name:SEOK CHEOL AHN, MD, PLLC
Entity Type:Organization
Organization Name:SEOK CHEOL AHN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEOK
Authorized Official - Middle Name:
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-863-3224
Mailing Address - Street 1:76 GREENVALE CIR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1602
Mailing Address - Country:US
Mailing Address - Phone:917-863-3224
Mailing Address - Fax:914-761-0573
Practice Address - Street 1:76 GREENVALE CIR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1602
Practice Address - Country:US
Practice Address - Phone:917-863-3224
Practice Address - Fax:914-761-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1937582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty