Provider Demographics
NPI:1659363232
Name:CHUNG, DEBORAH B (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DAE
Other - Middle Name:BONG
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 N HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2541
Mailing Address - Country:US
Mailing Address - Phone:845-452-1110
Mailing Address - Fax:845-452-1119
Practice Address - Street 1:223 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2770
Practice Address - Country:US
Practice Address - Phone:845-838-4900
Practice Address - Fax:845-838-4915
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1270681-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1270681-1OtherMD LICENSE
NYBC4110235OtherDEA LICENSE
F91880Medicare UPIN
NY1270681-1OtherMD LICENSE