Provider Demographics
NPI:1073890026
Name:CHUNG, SUNG HYUN (DPT)
Entity Type:Individual
Prefix:DR
First Name:SUNG
Middle Name:HYUN
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:DR
Other - First Name:SUNG
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:290 MADISON AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6306
Mailing Address - Country:US
Mailing Address - Phone:516-987-1700
Mailing Address - Fax:212-725-0577
Practice Address - Street 1:290 MADISON AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6306
Practice Address - Country:US
Practice Address - Phone:516-987-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033991-12251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic