MEDICARE: CHOON OK HONG PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R204812	MD

General Provider Information

NPI Number	:	1184570061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHOON OK HONG PMHNP

Provider Business Mailing Address
First Line	:	19650 CLUB HOUSE RD STE 202-A
Second Line	:
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-3003
Country	:	US
Telephone Number	:	301-337-9642
Fax Number	:	888-347-2510

Provider Business Practice Location Address
First Line	:	19650 CLUB HOUSE RD # 202-A
Second Line	:
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-3003
Country	:	US
Telephone Number	:	301-337-9642
Fax Number	:	888-347-2510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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