Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 338539 | NY |
NPI | 1003157751 |
---|---|
Provider Name | Jenny H Chung |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2013 |
Last Update Date | 14/07/2014 |