Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | C42362 | CA |
N | 208D00000X | General Practice Physician | C42362 | CA |
NPI | 1689070690 |
---|---|
Provider Name | Wonsick Choe |
First Address | Harrington Park, NJ 07640-1063 |
Second Address | Harrington Park, NJ 07640-1063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 18/11/2014 |