Provider Demographics
NPI:1902631906
Name:CHOI, KLARA
Entity type:Individual
Prefix:
First Name:KLARA
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1510
Mailing Address - Country:US
Mailing Address - Phone:631-742-0822
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1108
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6655
Practice Address - Country:US
Practice Address - Phone:212-960-8626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health