Organization
GRACE U CHUNG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE U CHUNG MD (OWNER)
(856) 853-0900
Entity
Organization
Contact information
Practice address
17 W RED BANK AVE, SUITE 205, WOODBURY, NJ 08096-1630
(856) 853-0900
(856) 853-5838
Mailing address
17 W RED BANK AVE, SUITE 205, WOODBURY, NJ 08096-1630
(856) 853-0900
(856) 853-5838
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MA55490
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0543745000
AMERIHEALTH GROUP #
NJ
05
—
197180801
—
NJ
01
—
24034
AETNA GROUP #
NJ
01
—
271880
AMERIHEALTH PPO GROUP #
NJ
Enumeration date
09/26/2006
Last updated
01/24/2013
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