Healthcare Provider Details

I. General information

NPI: 1144340225
Provider Name (Legal Business Name): ANTHONY HIGUK JUNG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HI GUK JUNG M.D.

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40-18MURRAY STREET
FLUSHING NY
11354-4934
US

IV. Provider business mailing address

40-18 MURRAY STREET
FLUSHING NY
11354-4934
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-6464
  • Fax: 718-939-6464
Mailing address:
  • Phone: 718-461-6464
  • Fax: 718-939-6464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number182552
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: