Provider Demographics
NPI:1174564140
Name:CHOI, YOUNG K (MD)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:K
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 ROUTE 27, UNIT 3
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3477
Mailing Address - Country:US
Mailing Address - Phone:732-287-1990
Mailing Address - Fax:732-287-1996
Practice Address - Street 1:1581 ROUTE 27, UNIT 3
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3477
Practice Address - Country:US
Practice Address - Phone:732-287-1990
Practice Address - Fax:732-287-1996
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 56781207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5418704Medicaid
NJ126524Medicare PIN
NJC30966Medicare UPIN