Active NPI
Suji Jung
- Registered Dietitian
- Astoria, NY
National Provider Identifier
1316577083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86132713
- Practice address
- 3118 Crescent St Apt 4D
Astoria, NY 11106-3779 - Phone
- (917) 488-0740
- NPI assigned
- Jan 22, 2020
- Last updated
- Jan 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86132713 | NY | Primary |
Addresses
Primary practice location
3118 Crescent St Apt 4D
Astoria, NY 11106-3779
Mailing address
3118 Crescent St Apt 4D
Astoria, NY 11106-3779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86132713 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1316577083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3118 CRESCENT ST APT 4D",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111063779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3118 CRESCENT ST APT 4D",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111063779",
"telephone_number": "917-488-0740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "SUJI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-22",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86132713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.