Provider Demographics
NPI:1720010820
Name:TIEN, HUEY CHUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:HUEY
Middle Name:CHUNG
Last Name:TIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PELLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9648
Mailing Address - Country:US
Mailing Address - Phone:973-322-5437
Mailing Address - Fax:973-322-8833
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5437
Practice Address - Fax:973-322-8833
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04259300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3814700Medicaid
NJ0578085Medicare ID - Type Unspecified
NJ3814700Medicaid