Healthcare Provider Details

I. General information

NPI: 1588548275
Provider Name (Legal Business Name): WOOSEOK CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STANLEY S. BERGEN BUILDING, 65 BERGEN ST
NEWARK NJ
07107
US

IV. Provider business mailing address

100 SCHINLDER CT. APT 412
EAST RUTHERFORD NJ
07073
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-4307
  • Fax:
Mailing address:
  • Phone: 512-393-1891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ15632000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: