Provider Demographics
NPI:1730187352
Name:CHOY, WANDA (MD)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:CHOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E RIDGEWOOD AVE STE WEST303
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3957
Mailing Address - Country:US
Mailing Address - Phone:201-689-7755
Mailing Address - Fax:201-689-0521
Practice Address - Street 1:1200 E RIDGEWOOD AVE STE WEST303
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3957
Practice Address - Country:US
Practice Address - Phone:201-689-7755
Practice Address - Fax:201-689-0521
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ69136207RC0200X
NJ63136207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2448077OtherAETNA
34233OtherMASTERCARE
P1911507OtherOXFORD
1K5711OtherHEALTHNET
NJ7999402Medicaid
43579914004OtherCIGNA
34233OtherMASTERCARE
NJG90461Medicare UPIN