Basic Information
Provider Information
NPI: 1538520440
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOI
FirstName: MYUNG SUN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1425 PORTLAND AVE STE 204
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146213011
CountryCode: US
TelephoneNumber: 5859225067
FaxNumber: 5859224778
Practice Location
Address1: 1425 PORTLAND AVE STE 204
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146213011
CountryCode: US
TelephoneNumber: 5859225067
FaxNumber: 5859224778
Other Information
ProviderEnumerationDate: 03/19/2016
LastUpdateDate: 09/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X297993NYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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