Provider Demographics
NPI:1760650014
Name:TUNG, NGOOK K (RN)
Entity Type:Individual
Prefix:MISS
First Name:NGOOK
Middle Name:K
Last Name:TUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BURKHALL STREET
Mailing Address - Street 2:UNIT #611
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-3500
Mailing Address - Country:US
Mailing Address - Phone:781-535-8486
Mailing Address - Fax:
Practice Address - Street 1:160 BURKHALL STREET
Practice Address - Street 2:UNIT #611
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-3500
Practice Address - Country:US
Practice Address - Phone:781-267-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252533163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA252533OtherRN LICENSE