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General NPI Number Information
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NPI Number | 1104397751
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Entity Type | Individual
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Provider Name | YEON SOO CHO L. AC.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2018
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 470 OCEAN AVE APT LD4
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City | BROOKLYN
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State | NY
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Zip | 11226-8714
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Country | US
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Telephone | 917-733-9139
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Fax |
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Provider Business Mailing Address
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Address Line | 470 OCEAN AVE APT LD4
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City | BROOKLYN
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State | NY
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Zip | 11226-8714
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Country | US
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Telephone | 917-733-9139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 006361-1
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License Number State | NY
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