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General NPI Number Information
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NPI Number | 1346543022
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Entity Type | Organization
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Legal Business Name | YE INTERVENTIONAL PAIN MANAGEMENT & MEDICAL, PC
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 2532 168TH ST # LL4
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City | FLUSHING
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State | NY
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Zip | 11358-1158
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Country | US
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Telephone | 718-355-8821
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Fax |
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Provider Business Mailing Address
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Address Line | 2532 168TH ST # LL4
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City | FLUSHING
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State | NY
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Zip | 11358-1158
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Country | US
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Telephone | 718-355-8821
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN CHO
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Credential | MD
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Telephone | 732-261-0720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 253261
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License Number State | NY
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