Provider Demographics
NPI:1881026557
Name:JUNG, SUN JOO L (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUN JOO
Middle Name:L
Last Name:JUNG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SUNNY
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:170 PARK ROW
Mailing Address - Street 2:#3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1146
Mailing Address - Country:US
Mailing Address - Phone:212-964-2980
Mailing Address - Fax:
Practice Address - Street 1:170 PARK ROW
Practice Address - Street 2:#3C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1146
Practice Address - Country:US
Practice Address - Phone:212-964-2980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010453235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist