Healthcare Provider Details

I. General information

NPI: 1265388276
Provider Name (Legal Business Name): JOHN CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 DELAWARE AVE APT 4
BUFFALO NY
14209-2034
US

IV. Provider business mailing address

219 LAUREL RD APT 613
VOORHEES NJ
08043-2345
US

V. Phone/Fax

Practice location:
  • Phone: 914-274-0927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number810073-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number810073-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: