MEDICARE: DR. SEA HYUN CHUNG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	229848	NY

General Provider Information

NPI Number	:	1073671400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEA HYUN CHUNG M.D.

Provider Business Mailing Address
First Line	:	39-25 UNION ST.
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354
Country	:	US
Telephone Number	:	718-460-4191
Fax Number	:	718-353-4645

Provider Business Practice Location Address
First Line	:	3925 UNION ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5513
Country	:	US
Telephone Number	:	718-460-4191
Fax Number	:	718-353-4645

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/26/2013

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