MEDICARE: HANNA SUN CHUNG M.S., R.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	133V00000X	Registered Dietitian	980304	NY

General Provider Information

NPI Number	:	1992093926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNA SUN CHUNG M.S., R.D.

Provider Business Mailing Address
First Line	:	792 STERLING PL
Second Line	:	APT 3C
City	:	BROOKLYN
State	:	NY
Zip	:	11216-3968
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	528 PROSPECT PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-4205
Country	:	US
Telephone Number	:	718-613-6800
Fax Number	:

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

Provider Enumeration Date	:	07/12/2011
Last Update Date	:	07/12/2011

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