Provider Demographics
NPI:1154776789
Name:CHOO, HEEMOON
Entity type:Individual
Prefix:MR
First Name:HEEMOON
Middle Name:
Last Name:CHOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 162ND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-4200
Mailing Address - Country:US
Mailing Address - Phone:718-594-3337
Mailing Address - Fax:973-915-7116
Practice Address - Street 1:4555 162ND ST APT 1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-4200
Practice Address - Country:US
Practice Address - Phone:718-594-3337
Practice Address - Fax:973-915-7116
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001363171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist