Provider Demographics
NPI:1689663353
Name:JUNG, JOSEPHINE O (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:O
Last Name:JUNG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1575 HILLSIDE AVE
Mailing Address - Street 2:302
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2521
Mailing Address - Country:US
Mailing Address - Phone:516-775-8000
Mailing Address - Fax:516-775-8001
Practice Address - Street 1:1575 HILLSIDE AVE
Practice Address - Street 2:302
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2521
Practice Address - Country:US
Practice Address - Phone:516-775-8000
Practice Address - Fax:167-775-8001
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2021-09-27
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Provider Licenses
StateLicense IDTaxonomies
NY199987208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01724047Medicaid