Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 26NJ00951700 | NJ |
NPI | 1003460486 |
---|---|
Provider Name | Casey Yeonjoo Cho |
First Address | Newark, NJ 07112-2027 |
Second Address | Newark, NJ 07112-2027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2019 |
Last Update Date | 20/04/2020 |