Provider Demographics
NPI:1609861244
Name:BAI, CHUN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUN
Middle Name:
Last Name:BAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:268 NEAL DOW AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3128
Mailing Address - Country:US
Mailing Address - Phone:732-508-3222
Mailing Address - Fax:347-770-8011
Practice Address - Street 1:864 59TH STREET
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3293
Practice Address - Country:US
Practice Address - Phone:347-240-1690
Practice Address - Fax:347-915-0195
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227032-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02440279Medicaid
NY522N21Medicare ID - Type Unspecified
NY02440279Medicaid