Healthcare Provider Details

I. General information

NPI: 1558209346
Provider Name (Legal Business Name): HAYEON CHUNG
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 TEANECK RD
TEANECK NJ
07666-4245
US

IV. Provider business mailing address

7 S HIGHLAND AVE UNIT 201
NYACK NY
10960-2689
US

V. Phone/Fax

Practice location:
  • Phone: 201-833-3000
  • Fax:
Mailing address:
  • Phone: 512-203-6195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: