Provider Demographics
NPI:1811608243
Name:JUNG, KYUNG SIL (PHD)
Entity type:Individual
Prefix:DR
First Name:KYUNG SIL
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CAMERON RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2935
Mailing Address - Country:US
Mailing Address - Phone:201-694-3692
Mailing Address - Fax:
Practice Address - Street 1:1639 CENTER AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4740
Practice Address - Country:US
Practice Address - Phone:201-694-3692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling