Provider Demographics
NPI:1356371819
Name:CHUN, KYE S (DO)
Entity type:Individual
Prefix:
First Name:KYE
Middle Name:S
Last Name:CHUN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 ROUTE 516
Mailing Address - Street 2:STE 202
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4603
Mailing Address - Country:US
Mailing Address - Phone:201-951-0897
Mailing Address - Fax:
Practice Address - Street 1:55 - 59 WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2931
Practice Address - Country:US
Practice Address - Phone:973-616-7117
Practice Address - Fax:973-616-7338
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06411400207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKC05C94510OtherEMPIRE BC/BS
NJP2032183OtherOXFORD
NJ110214633OtherUNITED HEALTHCARE RAILROA
NJ00379TSDMedicare PIN
NJ110214633OtherUNITED HEALTHCARE RAILROA
NJ087606Medicare PIN