Individual
MITCHELL I CHOROST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16303 HORACE HARDING EXPY, SUITE 100, FRESH MEADOWS, NY 11365-1454
(718) 454-4600
(718) 454-3954
Mailing address
PO BOX 1054, PORT WASHINGTON, NY 11050-1054
(631) 465-6297
(631) 465-6524
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
205781
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02280835
—
NY
01
—
4324H1
BLUE CROSS BLUE SHIELD
NY
Enumeration date
05/25/2006
Last updated
06/30/2014
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