Provider Demographics
NPI:1366469116
Name:CHUNG, SUNYA (RN)
Entity Type:Individual
Prefix:MS
First Name:SUNYA
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SUNYA
Other - Middle Name:
Other - Last Name:ROGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4591 VERNON DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3457
Mailing Address - Country:US
Mailing Address - Phone:440-716-8477
Mailing Address - Fax:
Practice Address - Street 1:4591 VERNON DR
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3457
Practice Address - Country:US
Practice Address - Phone:440-716-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN281036163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2144165Medicaid