Provider Demographics
NPI:1770731176
Name:JUNG, MATHEW ERIC
Entity type:Individual
Prefix:MR
First Name:MATHEW
Middle Name:ERIC
Last Name:JUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 NORTH ST.
Mailing Address - Street 2:SUPPORTIVE AND INTENSIVE CASE MANAGEMENT
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528
Mailing Address - Country:US
Mailing Address - Phone:914-967-6500
Mailing Address - Fax:914-925-5160
Practice Address - Street 1:275 NORTH ST.
Practice Address - Street 2:SUPPORTIVE AND INTENSIVE CASE MANAGEMENT
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528
Practice Address - Country:US
Practice Address - Phone:914-967-6500
Practice Address - Fax:914-925-5160
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical