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NPI 1316259393

NPI 1316259393 : SYMONG CHOI DPT : ROOSEVELT, NY

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General NPI Number Information
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    NPI Number           |    1316259393
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    Entity Type          |    Individual 
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    Provider Name        |    SYMONG CHOI DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/08/2010
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    Last Update Date     |    03/30/2011
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Provider Practice Location Address
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    Address Line         |    380 WASHINGTON AVE 
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    City                 |    ROOSEVELT
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    State                |    NY
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    Zip                  |    11575-1845
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    Country              |    US
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    Telephone            |    516-378-2000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    380 WASHINGTON AVE 
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    City                 |    ROOSEVELT
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    State                |    NY
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    Zip                  |    11575-1845
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    Country              |    US
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    Telephone            |    516-378-2000
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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        |    2251P0200X
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    Taxonomy Name        |    Pediatric Physical Therapist
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    License Number       |    033536
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    License Number State |    NY
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