Healthcare Provider Details

I. General information

NPI: 1770867491
Provider Name (Legal Business Name): CHUNYIP HUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 SOUTH AVE
POUGHKEEPSIE NY
12601-4510
US

IV. Provider business mailing address

2280 82ND ST
BROOKLYN NY
11214-2604
US

V. Phone/Fax

Practice location:
  • Phone: 845-473-4820
  • Fax: 845-475-5284
Mailing address:
  • Phone: 917-362-0492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number055963
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: