Healthcare Provider Details

I. General information

NPI: 1720904949
Provider Name (Legal Business Name): SUNGYUN CHO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID CHO

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3074 WHITNEY AVE
HAMDEN CT
06518-2391
US

IV. Provider business mailing address

10 JEREMY GARDEN LN
WOODBRIDGE CT
06525-2044
US

V. Phone/Fax

Practice location:
  • Phone: 203-903-9363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: