MEDICARE: DR. CALEB YOUNG-JU CHUNG DPM

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
1	213EP1101X	Primary Podiatric Medicine Podiatrist	25MD00263100	NJ
2	213ER0200X	Radiology Podiatrist	25MD00263100	NJ
3	213ES0131X	Foot Surgery Podiatrist	25MD00263100	NJ
4	213E00000X	Podiatrist	25MD00263100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1953226	OTHER	NJ	FIRST HEALTH
2	38688	OTHER	NJ	MASTERCARE
3	2289032	OTHER	NJ	UNITEDHEALTH PLAN
4	8891202002	OTHER	NJ	CIGNA
5	PG6032	OTHER	NJ	WELL CHOICE
6	1147720	OTHER	NJ	HORIZON NJ HEALTH
7	1K8521	OTHER	NJ	HEALTHNET
8	2106180000	OTHER	NJ	AMERIHEALTH
9	33046	OTHER	NJ	UNIVERSITY HEALTH PLAN
10	967806	OTHER	NJ	ONE HEALTH PLAN
11	51508	OTHER	NJ	AMERIGROUP
12	85344	OTHER	NJ	OPERATING ENG LOCAL 825
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	P2525266	OTHER	NJ	OXFORD

General Provider Information

NPI Number	:	1962440164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CALEB YOUNG-JU CHUNG DPM

Provider Business Mailing Address
First Line	:	570 MAIN ST STE 101
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5058
Country	:	US
Telephone Number	:	201-363-1200
Fax Number	:	201-363-1600

Provider Business Practice Location Address
First Line	:	570 MAIN ST STE 101
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5058
Country	:	US
Telephone Number	:	201-363-1200
Fax Number	:	201-363-1600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	07/15/2022

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