Provider Demographics
NPI:1316254238
Name:CHO, ELI MANN (DPT)
Entity type:Individual
Prefix:
First Name:ELI
Middle Name:MANN
Last Name:CHO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HEMAN ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3059
Mailing Address - Country:US
Mailing Address - Phone:973-632-2651
Mailing Address - Fax:
Practice Address - Street 1:162 JOYSAN TER
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9304
Practice Address - Country:US
Practice Address - Phone:908-331-1654
Practice Address - Fax:732-359-1567
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01369400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist