Individual
JOHN J CHOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 READE PLACE, POUGHKEEPSIE, NY 12601
(845) 437-3003
Mailing address
1351 ROUTE 55 STE 200, LAGRANGEVILLE, NY 12540-5128
(845) 475-9661
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
261619
NY
208C00000X
Colon & Rectal Surgery Physician
261619
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03354143
—
NY
01
—
0A1095060
BLUE SHIELD PROVIDER NUMBER
CA
Enumeration date
09/21/2009
Last updated
08/23/2018
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