Individual
LANCE JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 CLOVE RD, STATEN ISLAND, NY 10301-3627
(718) 816-6440
(718) 816-3612
Mailing address
55 WATER ST, 12TH FL. CREDENTIALING, NEW YORK, NY 10041-0004
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
198410
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01825121
—
NY
Enumeration date
03/29/2006
Last updated
02/03/2017
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