Provider Demographics
NPI:1952306433
Name:CHEZ, TUNG S (MD FACC)
Entity Type:Individual
Prefix:DR
First Name:TUNG
Middle Name:S
Last Name:CHEZ
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 690060
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-0060
Mailing Address - Country:US
Mailing Address - Phone:212-740-0408
Mailing Address - Fax:212-740-5300
Practice Address - Street 1:513 W 179TH ST
Practice Address - Street 2:APT 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5708
Practice Address - Country:US
Practice Address - Phone:212-740-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187002207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
1024836OtherAETNA
1000023248OtherAFFINITY HEALTH PLAN
2593560OtherGHI
NY01382085Medicaid
2815958013OtherCIGNA
NY08L953OtherBCBS EMPIRE INDIVIDUAL
1534134OtherUNITEDHEALTHCARE COMMERCI
NY297228OtherWELLCARE
NY4C4911OtherHEALTHNET (PHS)
NY187002OtherHIP NEW YORK
2501740OtherUNITEDHEALTHCARE GVT
NY31C0691OtherCOMMUNITY PREMIER PLUS
NYIM172ACOtherCIGNA 2
P2046043OtherOXFORD
1024836OtherAETNA
NY4C4911OtherHEALTHNET (PHS)