Provider Demographics
NPI:1679659015
Name:JUNG, SUNNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUNNA
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 W 9TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8905
Mailing Address - Country:US
Mailing Address - Phone:212-744-1480
Mailing Address - Fax:
Practice Address - Street 1:12 W 9TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8905
Practice Address - Country:US
Practice Address - Phone:212-744-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017105103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist