Healthcare Provider Details

I. General information

NPI: 1730409541
Provider Name (Legal Business Name): DAVID CHOI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVENUE
FARMINGTON CT
06030
US

IV. Provider business mailing address

263 FARMINGTON AVENUE
FARMINGTON CT
06030-8082
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-8080
  • Fax: 860-679-0131
Mailing address:
  • Phone: 860-679-8080
  • Fax: 860-679-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD15817
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number059992
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: