MEDICARE: YEAHSEON CHOI BRUININGS MD

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	207Q00000X	Family Medicine Physician	226709	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770580235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEAHSEON CHOI BRUININGS MD

Provider Business Mailing Address
First Line	:	3438 BELL BLVD
Second Line	:	PH FLOOR 5
City	:	BAYSIDE
State	:	NY
Zip	:	11361-1730
Country	:	US
Telephone Number	:	718-360-5768
Fax Number	:	718-224-5885

Provider Business Practice Location Address
First Line	:	3438 BELL BLVD
Second Line	:	PH FLOOR 5
City	:	BAYSIDE
State	:	NY
Zip	:	11361-1730
Country	:	US
Telephone Number	:	718-360-5768
Fax Number	:	718-224-5885

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	01/21/2013

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Directions to “ YEAHSEON CHOI BRUININGS MD” Practice Location

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