Healthcare Provider Details

I. General information

NPI: 1124043484
Provider Name (Legal Business Name): ALEXANDER J CHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # 695
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 EAST 68TH STREET PAYSON 695
NY NY
10065
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-3400
  • Fax:
Mailing address:
  • Phone: 212-746-3400
  • Fax: 212-746-8609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number215553
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number215553
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: