Healthcare Provider Details

I. General information

NPI: 1982526869
Provider Name (Legal Business Name): TATJANA J CHUNG MSN,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 HENRY HUDSON PKWY APT 102
BRONX NY
10463-4740
US

IV. Provider business mailing address

2727 HENRY HUDSON PKWY APT 102
BRONX NY
10463-4740
US

V. Phone/Fax

Practice location:
  • Phone: 917-684-5073
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360331-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: