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General NPI Number Information
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NPI Number | 1942557376
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Entity Type | Individual
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Provider Name | BRYAN CHUNG
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Gender | Male
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Dates
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Enumeration Date | 08/03/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 462 1ST AVE BOGERT EDUCATION CENTER, CD522
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City | NEW YORK
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State | NY
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Zip | 10016-9196
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Country | US
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Telephone | 212-263-8279
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Fax |
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Provider Business Mailing Address
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Address Line | 321 E 22ND ST 6J
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City | NEW YORK
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State | NY
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Zip | 10010-4802
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Country | US
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Telephone | 917-288-5155
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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