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General NPI Number Information
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NPI Number | 1568195121
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Entity Type | Individual
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Provider Name | HA-EUN CHUNG OD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 115 E 61ST ST STE 1B
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City | NEW YORK
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State | NY
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Zip | 10065-8184
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Country | US
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Telephone | 212-355-2215
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Fax |
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Provider Business Mailing Address
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Address Line | 235 W END AVE APT 3B
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City | NEW YORK
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State | NY
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Zip | 10023-3637
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009577
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License Number State | NY
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