Provider Demographics
NPI:1578579504
Name:CHUNG, WILLIAM B (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 PORT WASHINGTON BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576
Mailing Address - Country:US
Mailing Address - Phone:516-390-9640
Mailing Address - Fax:516-390-9650
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576
Practice Address - Country:US
Practice Address - Phone:516-390-9640
Practice Address - Fax:516-390-9650
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY257603207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease