Provider Demographics
NPI:1497350490
Name:CHUN, JOSEPHINE UNSIL
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:UNSIL
Last Name:CHUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 SELDEN PL
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5235
Mailing Address - Country:US
Mailing Address - Phone:917-733-9371
Mailing Address - Fax:
Practice Address - Street 1:1343 SELDEN PL
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5235
Practice Address - Country:US
Practice Address - Phone:917-733-9371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02810200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty