Provider Demographics
NPI:1326511668
Name:GURUNG, CHHUNTA (RN,BSN)
Entity Type:Individual
Prefix:
First Name:CHHUNTA
Middle Name:
Last Name:GURUNG
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 51ST AVE APT 7C
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3984
Mailing Address - Country:US
Mailing Address - Phone:917-327-2634
Mailing Address - Fax:
Practice Address - Street 1:8829 51ST AVE APT 7C
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3984
Practice Address - Country:US
Practice Address - Phone:917-327-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY758537-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse