Individual
MIRIAM ELIZABETH CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
405 LEXINGTON AVE, SUITE 6900, NEW YORK, NY 10174-0002
(215) 594-9364
Mailing address
3450 WAYNE AVE, APT 9K, BRONX, NY 10467-2510
(215) 594-9364
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
057798
NY
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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