Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 217642-1 | NY |
NPI | 1003843673 |
---|---|
Provider Name | Hyun Chung |
First Address | Livingston, NJ 07039-0658 |
Second Address | New Rochelle, NY 10801-5503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H74694 | (02) | NY |