=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679721732
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHUNGFAI TUNG M.D. P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2008
-----------------------------------------------------
Last Update Date | 10/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 E BROADWAY STE 803
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10002-7187
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-608-8070
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 E BROADWAY STE 803
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10002-7187
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-608-8070
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHAIRMAN
-----------------------------------------------------
Name | DR. CHUNGFAI TUNG
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 212-608-8070
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number | 239306
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | 239306
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------