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General NPI Number Information
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NPI Number | 1396952826
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Entity Type | Individual
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Provider Name | SUE CHUNG
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 750 PARK PL # 790
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City | LONG BEACH
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State | NY
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Zip | 11561-2110
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Country | US
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Telephone | 516-536-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 21907 67TH AVE APT # C
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-2638
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Country | US
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Telephone | 718-428-2426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 039377
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License Number State | NY
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