MEDICARE: MR. JOHNNY CHUNG RPH

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	183500000X	Pharmacist	054057	NY

General Provider Information

NPI Number	:	1215250733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHNNY CHUNG RPH

Provider Business Mailing Address
First Line	:	949 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-2702
Country	:	US
Telephone Number	:	212-223-1765
Fax Number	:

Provider Business Practice Location Address
First Line	:	949 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-2702
Country	:	US
Telephone Number	:	212-223-1765
Fax Number	:

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

Provider Enumeration Date	:	03/11/2010
Last Update Date	:	06/02/2021

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Directions to “ MR. JOHNNY CHUNG RPH” Practice Location

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