Provider Demographics
NPI:1083652606
Name:TUN-CHIONG, YOLANDA (DO)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:TUN-CHIONG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 MOTT ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5540
Mailing Address - Country:US
Mailing Address - Phone:646-355-3711
Mailing Address - Fax:212-300-4989
Practice Address - Street 1:128 MOTT ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5540
Practice Address - Country:US
Practice Address - Phone:646-355-3711
Practice Address - Fax:212-300-4989
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2723251Medicaid
NY2723251Medicaid
NYI45870Medicare UPIN