Provider Demographics
NPI:1891950382
Name:FUNG, GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:FUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 WASHINGTON BOULEVARD, 4TH FLOOR
Mailing Address - Street 2:STAMFORD HOSPITAL FAMILY MEDICINE RESIDENCY PROGRAM
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-276-1000
Mailing Address - Fax:203-276-2413
Practice Address - Street 1:1351 WASHINGTON BOULEVARD, 4TH FLOOR
Practice Address - Street 2:STAMFORD HOSPITAL FAMILY MEDICINE RESIDENCY PROGRAM
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-276-1000
Practice Address - Fax:203-276-2413
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program