Individual
CHARLES I CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
223 MAIN ST, BEACON, NY 12508-2770
(845) 838-4900
(845) 838-4900
Mailing address
223 MAIN ST, BEACON, NY 12508-2770
(845) 838-4900
(845) 838-4900
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
125840-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125840-1
NYS MD LICENSE
NY
Enumeration date
07/10/2006
Last updated
07/08/2007
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