Healthcare Provider Details

I. General information

NPI: 1730761792
Provider Name (Legal Business Name): MARTIN CHUN LICENSED SOCIAL WORK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WHITEHORSE MERCERVILLE RD BLDG B
HAMILTON NJ
08619-3882
US

IV. Provider business mailing address

608 LAKEVIEW TER
PRINCETON NJ
08540-5727
US

V. Phone/Fax

Practice location:
  • Phone: 609-256-4200
  • Fax: 609-581-1623
Mailing address:
  • Phone: 908-578-6607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06349400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: