Provider Demographics
NPI:1851459895
Name:CHUNG, ROGER MAN NING (MBBS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:MAN NING
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:139 CENTRE ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4552
Mailing Address - Country:US
Mailing Address - Phone:212-966-2818
Mailing Address - Fax:212-966-2852
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4552
Practice Address - Country:US
Practice Address - Phone:212-966-2818
Practice Address - Fax:212-966-2852
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233595207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI45398Medicare UPIN