Healthcare Provider Details

I. General information

NPI: 1982913885
Provider Name (Legal Business Name): PEI-CHI CHUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 9TH AVE 2ND FLOOR
NEW YORK NY
10001-5701
US

IV. Provider business mailing address

4209 28TH ST # CN-48
LONG ISLAND CITY NY
11101-4130
US

V. Phone/Fax

Practice location:
  • Phone: 347-396-6299
  • Fax:
Mailing address:
  • Phone: 473-963-6299
  • Fax: 347-396-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number226842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: