Healthcare Provider Details

I. General information

NPI: 1417725854
Provider Name (Legal Business Name): ESTHER JUNG , FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 216TH ST
BAYSIDE NY
11360-2810
US

IV. Provider business mailing address

2901 216TH ST
BAYSIDE NY
11360-2810
US

V. Phone/Fax

Practice location:
  • Phone: 917-494-3544
  • Fax: 718-281-8590
Mailing address:
  • Phone: 718-281-8827
  • Fax: 718-281-8590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF352686-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: