Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 057128 | NY |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 22DI02563600 | NJ |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DN013572 | GA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 25MA09486700 | NJ |
N | 204E00000X | Oral & Maxillofacial Surgeon | 274404 | NY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 68711 | GA |
NPI | 1427220029 |
---|---|
Provider Name | Sung Hee Cho |
First Address | River Edge, NJ 07661-1931 |
Second Address | River Edge, NJ 07661-1931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2008 |
Last Update Date | 20/06/2014 |