Provider Demographics
NPI:1578852778
Name:KOH, ALBERT SUNG JIN (DO)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:SUNG JIN
Last Name:KOH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 WAYNE AVE
Mailing Address - Street 2:APT # 19E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3450 WAYNE AVE
Practice Address - Street 2:APT # 19E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2510
Practice Address - Country:US
Practice Address - Phone:917-923-7612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260159207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine