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General NPI Number Information
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NPI Number | 1821556473
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Entity Type | Individual
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Provider Name | JU YOUN JUNG
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Gender | Female
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Dates
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Enumeration Date | 03/03/2019
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Last Update Date | 03/03/2019
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Provider Practice Location Address
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Address Line | 550 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 646-929-7870
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Fax |
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Provider Business Mailing Address
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Address Line | 24757 GRAND HARBOR DR APT 515
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City | KATY
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State | TX
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Zip | 77494-0757
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Country | US
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Telephone | 347-225-6191
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 431411
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License Number State | NY
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