Provider Demographics
NPI:1740586163
Name:CHUNG, NAM-YOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:NAM-YOUNG
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:NAM-YOUNG
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1640 SCHLOSSER ST STE C3
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5656
Mailing Address - Country:US
Mailing Address - Phone:201-808-8610
Mailing Address - Fax:201-875-5443
Practice Address - Street 1:51 CONGRESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2134
Practice Address - Country:US
Practice Address - Phone:201-808-8610
Practice Address - Fax:201-875-5443
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08532100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics