Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA02805200 | NJ |
NPI | 1023190667 |
---|---|
Provider Name | Dong W Cho |
First Address | West Orange, NJ 07052-1426 |
Second Address | West Orange, NJ 07052-1426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40288 | AETNA (01) | NJ |
C53588 | (02) | NJ |
ES331 | OXFORD (01) | NJ |