Provider Demographics
NPI:1821077868
Name:CHUNG, HEI JIN (MD)
Entity Type:Individual
Prefix:MRS
First Name:HEI JIN
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1971
Mailing Address - Country:US
Mailing Address - Phone:908-859-5676
Mailing Address - Fax:908-859-2576
Practice Address - Street 1:601 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1971
Practice Address - Country:US
Practice Address - Phone:908-859-5676
Practice Address - Fax:908-859-2576
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA072934174400000X
PAMD074263L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA270008717OtherQUALCARE
NJ85954OtherLOCAL 825
PACH1425338OtherPA BLUE SHIELD
NJ2109928000OtherAMERIHEALTHKEYSTONE
NJ11136559OtherMULTIPLAN
NJ7443025OtherAETNA TRADITIONAL
NJ01000442-00OtherAMERICHOICE
NJ270008717OtherHORIZON
NJAMERIGROUPOtherAMERIGROUP
NJ0198951OtherGHI
NJ8938105Medicaid
NJAMERIHEALTHOtherAMERIHEALTH
NJNJ CARPENTERSOtherNJ CARPENTERS
NJ2811617OtherAETNA HMO
NJ270008717OtherCHN
NJCIGNAOther4888037004
NJP2667606OtherOXFORD
NJ85954OtherLOCAL 825
NJ2109928000OtherAMERIHEALTH+KEYSTONE
NJG97427Medicare UPIN