Individual
JAY SOO JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17TH & CHEW STREET, ALLENTOWN, PA 18102
(610) 402-9029
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-9080
(610) 402-9029
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD031217L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093531
THREE RIVERS
PA
01
—
0006219430002
PA MEDICAID
PA
01
—
0040562000
INDEP. BLUE CROSS
PA
01
—
00621943
GATEWAY
PA
01
—
0095960
KHP CENTRAL
PA
01
—
095960
HIGHMARK
PA
01
—
1010381
AMERIHEALTH MERCY
PA
Enumeration date
10/17/2005
Last updated
07/09/2007
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