Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 15092 | NY |
Y | 103TC0700X | Clinical Psychologist | 15092 | NY |
NPI | 1003830944 |
---|---|
Provider Name | Poyoon Choi |
First Address | Roslyn, NY 11576-2606 |
Second Address | Elmhurst, NY 11373-4434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 06/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02246257 | (05) | NY |
0281EL | GHI MEDICARE (01) | NY |
0281EM | GHI MEDICARE (01) | NY |
0281EN | GHI MEDICARE (01) | NY |