Provider Demographics
NPI:1215188214
Name:CHUNG, DOREEN E (MD)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:E
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:161 FORT WASHINGTON AVE
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:212-305-0114
Mailing Address - Fax:212-305-0129
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-0114
Practice Address - Fax:212-305-0129
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2014-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY277192208800000X, 2088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery