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General NPI Number Information
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NPI Number | 1437611696
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Entity Type | Individual
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Provider Name | SUNGSIL CHO MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 23 CLARA DR
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City | MYSTIC
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State | CT
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Zip | 06355-1959
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Country | US
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Telephone | 860-572-5782
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Fax |
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Provider Business Mailing Address
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Address Line | 99 HAWLEY LN FL 3
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City | STRATFORD
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State | CT
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Zip | 06614-1202
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Country | US
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Telephone | 860-572-5782
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 72263
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License Number State | CT
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