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NPI 1801839501

NPI 1801839501 : SAMUEL CHO M.D. : FLUSHING, NY

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General NPI Number Information
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    NPI Number           |    1801839501
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    Entity Type          |    Individual 
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    Provider Name        |    SAMUEL CHO M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/13/2006
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    Last Update Date     |    12/15/2014
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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    |    
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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        |    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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