Provider Demographics
NPI:1619100526
Name:CHUNG, STEVEN S (LAC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:S
Last Name:CHUNG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4046
Mailing Address - Country:US
Mailing Address - Phone:646-259-2874
Mailing Address - Fax:
Practice Address - Street 1:596 ANDERSON AVE STE 104
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1888
Practice Address - Country:US
Practice Address - Phone:646-259-2874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00067800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist