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General NPI Number Information
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NPI Number | 1972213783
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Entity Type | Individual
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Provider Name | DAVID JUNG
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Gender | Male
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 41 CROSSROADS PLZ # 258
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2402
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Country | US
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Telephone | 347-338-0876
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Fax |
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Provider Business Mailing Address
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Address Line | 41 CROSSROADS PLZ # 258
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2402
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11604
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 090296
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1150309
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95028851
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209029476
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN03493
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License Number State | RI
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404648-01
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License Number State | NY
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