Provider Demographics
NPI:1811055155
Name:CHO, KAB JAE (ACUPUNCTURIST)
Entity type:Individual
Prefix:DR
First Name:KAB
Middle Name:JAE
Last Name:CHO
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 82 162 STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1609
Mailing Address - Country:US
Mailing Address - Phone:718-461-2737
Mailing Address - Fax:
Practice Address - Street 1:35 82 162 STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1609
Practice Address - Country:US
Practice Address - Phone:718-460-1722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002162171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist