Healthcare Provider Details

I. General information

NPI: 1841398989
Provider Name (Legal Business Name): EDWARD HYUNG KOO RHEW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 SELWYN AVE DEPARTMENT OF ANESTHESIOLOGY
BRONX NY
10457-7626
US

IV. Provider business mailing address

11 HARRINGTON CT
HARRINGTON PARK NJ
07640-1100
US

V. Phone/Fax

Practice location:
  • Phone: 718-466-8153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number241519
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: