Provider Demographics
NPI:1720345424
Name:CHO, YOON-JUNG DIANNA (OD)
Entity type:Individual
Prefix:DR
First Name:YOON-JUNG
Middle Name:DIANNA
Last Name:CHO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DIANNA
Other - Middle Name:
Other - Last Name:CHO-LYON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:56 W EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1447
Mailing Address - Country:US
Mailing Address - Phone:610-446-8080
Mailing Address - Fax:610-446-1735
Practice Address - Street 1:56 W EAGLE RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-1447
Practice Address - Country:US
Practice Address - Phone:610-446-8080
Practice Address - Fax:610-446-1735
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist