Healthcare Provider Details

I. General information

NPI: 1447573639
Provider Name (Legal Business Name): DONG MIN CHO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 MAIN ST
SOUTH FARMINGDALE NY
11735-5426
US

IV. Provider business mailing address

918 MAIN ST
SOUTH FARMINGDALE NY
11735-5426
US

V. Phone/Fax

Practice location:
  • Phone: 516-845-5235
  • Fax: 516-845-5263
Mailing address:
  • Phone: 516-845-5235
  • Fax: 516-845-5263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050805
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050805-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: