Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 149923 | NY |
NPI | 1154546752 |
---|---|
Provider Name | Mr. Kyung Soo Cha |
First Address | New York, NY 10001 |
Second Address | New York, NY 10001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00829089 | (05) | NY |