Provider Demographics
NPI:1306363312
Name:JUNG, DAVID KUN HO (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KUN HO
Last Name:JUNG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 48TH AVE APT 5E
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5931
Mailing Address - Country:US
Mailing Address - Phone:213-393-0099
Mailing Address - Fax:
Practice Address - Street 1:2420 JACKSON AVE STE 205
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4332
Practice Address - Country:US
Practice Address - Phone:347-561-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042140-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist