Provider Demographics
NPI:1417179698
Name:CHUN, KYUNG S (MD)
Entity Type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:S
Last Name:CHUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5324
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-0324
Mailing Address - Country:US
Mailing Address - Phone:518-458-2481
Mailing Address - Fax:518-489-4149
Practice Address - Street 1:1 COMPUTER DRIVE SOUTH
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-0324
Practice Address - Country:US
Practice Address - Phone:518-458-2481
Practice Address - Fax:518-489-4149
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1214222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53574RMedicare ID - Type Unspecified
NYJ400002399Medicare PIN