Provider Demographics
NPI:1891077400
Name:TUNG, KIRK C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:C
Last Name:TUNG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 YORK DR
Mailing Address - Street 2:APT 6A
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4954
Mailing Address - Country:US
Mailing Address - Phone:908-208-5849
Mailing Address - Fax:
Practice Address - Street 1:1197 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2536
Practice Address - Country:US
Practice Address - Phone:732-549-3875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03033700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist