Provider Demographics
NPI:1639317126
Name:CHUN, WHA JIN (TERRY) (OD)
Entity Type:Individual
Prefix:DR
First Name:WHA JIN (TERRY)
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W 102ND ST APT 41
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4925
Mailing Address - Country:US
Mailing Address - Phone:917-225-3766
Mailing Address - Fax:
Practice Address - Street 1:240 W 102ND ST APT 41
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4925
Practice Address - Country:US
Practice Address - Phone:917-225-3766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV6153-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist