Provider Demographics
NPI:1275661415
Name:TUNG S CHEZ MD PC
Entity Type:Organization
Organization Name:TUNG S CHEZ MD PC
Other - Org Name:TUNG S CHEZ MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TUNG
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-740-0408
Mailing Address - Street 1:PO BOX 690060
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-0060
Mailing Address - Country:US
Mailing Address - Phone:212-740-0408
Mailing Address - Fax:
Practice Address - Street 1:513 W 179TH ST
Practice Address - Street 2:APT 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5708
Practice Address - Country:US
Practice Address - Phone:212-740-0408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY447Q81OtherEMPIRE BCBS GROUP