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Individual

DR. GRACE U CHUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
17 W. RED BANK AVE, SUITE 205, WOODBURY, NJ 08096
(856) 853-0900
(856) 853-5838
Mailing address
17 W. RED BANK AVE, SUITE 205, WOODBURY, NJ 08096
(856) 853-0900
(856) 853-5838

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA05549000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0463503000
AMERIHEALTH
NJ
05
1971808
NJ
05
197180801
NJ
01
24034
AETNA US HEALTHCARE
NJ
01
633461
BLUE SHIELD
NJ
Enumeration date
11/15/2005
Last updated
07/11/2013
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