Provider Demographics
NPI:1619209970
Name:JUNG, DANIEL M (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:M
Last Name:JUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12-33 DIANE PLACE #2
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1296
Mailing Address - Country:US
Mailing Address - Phone:646-369-5979
Mailing Address - Fax:
Practice Address - Street 1:22470 76TH RD
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3014
Practice Address - Country:US
Practice Address - Phone:718-217-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist