Provider Demographics
NPI:1164782256
Name:JUNG, YUKYUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:YUKYUNG
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YUKYUNG
Other - Middle Name:MICHELLE
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:595 GERARD AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5239
Mailing Address - Country:US
Mailing Address - Phone:718-742-6061
Mailing Address - Fax:718-742-6016
Practice Address - Street 1:1617 HEMPHILL ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4709
Practice Address - Country:US
Practice Address - Phone:817-702-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2733332084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry