Provider Demographics
NPI:1114196714
Name:CHO, YOEN (RPT)
Entity type:Individual
Prefix:
First Name:YOEN
Middle Name:
Last Name:CHO
Suffix:
Gender:
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21915A NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3525
Mailing Address - Country:US
Mailing Address - Phone:718-423-3400
Mailing Address - Fax:888-391-2482
Practice Address - Street 1:21915A NORTHERN BLVD # 1
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3525
Practice Address - Country:US
Practice Address - Phone:184-233-4007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007638171100000X
NY023165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist