Individual
DR. RICHARD SUN JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
270 E MAIN ST, BAY SHORE, NY 11706-8420
(631) 591-7450
Mailing address
270 E MAIN ST, BAY SHORE, NY 11706-8420
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
2013006676
MO
2084N0400X
Neurology Physician
2013006676
MO
2084N0400X
Neurology Physician
316974
NY
2084V0102X
Vascular Neurology Physician
2013006676
MO
2084V0102X
Vascular Neurology Physician
Primary
316974
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477732477
—
MO
01
—
2500017477
MO LICENSE
MO
01
—
316974
NY LICENSE
NY
Enumeration date
10/26/2007
Last updated
07/25/2024
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