Individual
JAE WOO CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1231 DEER PARK AVE, NORTH BABYLON, NY 11703
(631) 667-0388
Mailing address
1231 DEER PARK AVE, NORTH BABYLON, NY 11703-3104
(631) 667-0388
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N0069351
NY
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/05/2015
Last updated
07/31/2018
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