Provider Demographics
NPI:1326477290
Name:CHUN, SUN (LAC)
Entity Type:Individual
Prefix:MS
First Name:SUN
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 65TH AVE
Mailing Address - Street 2:APT 5E
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1404
Mailing Address - Country:US
Mailing Address - Phone:917-721-3866
Mailing Address - Fax:
Practice Address - Street 1:10810 65TH AVE
Practice Address - Street 2:APT 5E
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1404
Practice Address - Country:US
Practice Address - Phone:917-721-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001690171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist