Individual
CHUNG-TAIK CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-5276
(315) 464-5939
Mailing address
60 PRESIDENTIAL PLZ, MADISON TOWERS SUITE 208, SYRACUSE, NY 13202-2292
(315) 464-2020
(315) 464-2025
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
119070
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00470195
—
NY
01
—
119070
NYS LICENSE
NY
Enumeration date
07/25/2006
Last updated
12/16/2009
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