Healthcare Provider Details

I. General information

NPI: 1053750034
Provider Name (Legal Business Name): SUNG WHANG DNP, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2013
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 9TH ST STE 300
PHILADELPHIA PA
19107-6810
US

IV. Provider business mailing address

211 S 9TH ST STE 300
PHILADELPHIA PA
19107-6810
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-9991
  • Fax: 215-955-6010
Mailing address:
  • Phone: 215-955-9991
  • Fax: 215-955-6010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP012896
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: