Provider Demographics
NPI:1669166948
Name:CHUNG, SAMANTHA (AUD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:93 OXBOW DR
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-3629
Mailing Address - Country:US
Mailing Address - Phone:860-994-7062
Mailing Address - Fax:
Practice Address - Street 1:100 CROSSING BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5555
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist