=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447464185
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHOI MEDICAL SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2007
-----------------------------------------------------
Last Update Date | 10/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3834 PARSONS BLVD SUITE# 1D
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-762-1710
-----------------------------------------------------
Fax | 718-762-1753
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3834 PARSONS BLVD SUITE# 1D
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-762-1710
-----------------------------------------------------
Fax | 718-762-1753
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ALEXANDER K. CHOI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 718-762-1710
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 163896
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------