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NPI Code Detail

MEDICARE: JIN H CHUNG

MEDICARE: JIN H CHUNG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist48408NY

General Provider Information

NPI Number : 1922320605
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIN H CHUNG
Provider Business Mailing Address
First Line : 4120 HEMPSTEAD TPKE
Second Line :
City : BETHPAGE
State : NY
Zip : 11714-5600
Country : US
Telephone Number : 516-520-8809
Fax Number : 516-520-2958
Provider Business Practice Location Address
First Line : 210 S BROADWAY
Second Line :
City : HICKSVILLE
State : NY
Zip : 11801-5002
Country : US
Telephone Number : 516-433-2711
Fax Number : 512-681-6422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2010
Last Update Date : 10/21/2020

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Directions to “ JIN H CHUNG ” Practice Location

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