Provider Demographics
NPI:1013296821
Name:DR. DUNGO ASSOCIATES, P.C.
Entity type:Organization
Organization Name:DR. DUNGO ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-653-1144
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07303-0477
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 9TH ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-1704
Practice Address - Country:US
Practice Address - Phone:201-653-1144
Practice Address - Fax:201-653-6104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04298200207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ118041Medicaid
NJ450454OtherMEDICARE ID-TYPE UNSPECIFIED
NJ450454OtherMEDICARE ID-TYPE UNSPECIFIED