Individual
MISS CRYSTAL AKEESHA CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
343 W 145TH ST, NEW YORK, NY 10031-5301
(212) 444-8877
Mailing address
1 MAYFLOWER AVE, MASSAPEQUA PARK, NY 11762-2619
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
029240-01
NY
Other
Enumeration date
01/12/2023
Last updated
04/14/2023
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