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General NPI Number Information
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NPI Number | 1598954489
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Entity Type | Organization
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Legal Business Name | SAMUEL CHO, M.D., P.C.
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 15011 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11354-3893
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Country | US
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Telephone | 718-460-9640
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Fax | 718-460-1451
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Provider Business Mailing Address
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Address Line | PO BOX 270
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-0270
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Country | US
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Telephone | 631-264-2035
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Fax | 631-264-1418
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMUEL CHO
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Credential | M.D.
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Telephone | 718-460-9640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 187204
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License Number State | NY
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