Individual
ICHABOD S JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
117 FOOTE AVE, SUITE 100, JAMESTOWN, NY 14701-6947
(716) 338-9200
(716) 338-9250
Mailing address
117 FOOTE AVE, SUITE 100, JAMESTOWN, NY 14701-6947
(716) 338-9200
(716) 338-9250
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
220355
NY
208800000X
Urology Physician
MD417045
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2163913
—
NY
Enumeration date
07/01/2006
Last updated
02/03/2011
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