Provider Demographics
NPI:1003076886
Name:SUH, JUNGMAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNGMAN
Middle Name:MICHAEL
Last Name:SUH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18901 NORTHERN BLVD # 3F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2824
Mailing Address - Country:US
Mailing Address - Phone:718-746-0900
Mailing Address - Fax:718-746-2390
Practice Address - Street 1:18901 NORTHERN BLVD # 3F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2824
Practice Address - Country:US
Practice Address - Phone:718-746-0900
Practice Address - Fax:718-746-2390
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2435832084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology