Provider Demographics
NPI:1215102611
Name:CHOI, EDWARD WON (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WON
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56-45 MAIN STREET
Mailing Address - Street 2:NEW YORK HOSPITAL QUEENS DEPARTMENT OF EMERGENCY
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-670-1100
Mailing Address - Fax:
Practice Address - Street 1:56-45 MAIN STREET
Practice Address - Street 2:NEW YORK HOSPITAL QUEENS DEPARTMENT OF EMERGENCY
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253805207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00871378OtherRAILROAD MEDICARE
NY03190943Medicaid
NYP00871378OtherRAILROAD MEDICARE