1295058774 NPI number — KUN H CHO MD PA

Table of content: (NPI 1295058774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295058774 NPI number — KUN H CHO MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KUN H CHO MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295058774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 FULD ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08638-5247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-393-3571
Provider Business Mailing Address Fax Number:
609-989-1153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 FULD ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08638-5247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-393-3571
Provider Business Practice Location Address Fax Number:
609-989-1153
Provider Enumeration Date:
03/11/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CHO
Authorized Official First Name:
KUN
Authorized Official Middle Name:
HO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
609-393-3571

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1294105 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20376 . This is a "AMERGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 91000336701 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P62250338 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0089286000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: OK7788 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: TID4576971 . This is a "PRUCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1024979 . This is a "HMOBLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 366.4206 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7185 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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