Provider Demographics
NPI:1992301956
Name:CHOI, JEEWOONG (PHARMD)
Entity type:Individual
Prefix:
First Name:JEEWOONG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 LONGWOOD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5723
Mailing Address - Country:US
Mailing Address - Phone:617-731-8665
Mailing Address - Fax:
Practice Address - Street 1:350 LONGWOOD AVE STE B
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5723
Practice Address - Country:US
Practice Address - Phone:617-731-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH237505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist