Kon D Chun, MD – Anesthesiology Physician

Key facts

NPI: 1659358802
Entity type: Individual (NPI type 1)
Primary specialty: Anesthesiology Physician 207L00000X
License: 178921-1 (NY)
Practice address: 333 Route 25a
Ste 225
Rocky Point, NY 11778-8802
Phone: (631) 744-3671
Fax: (631) 744-6205
NPI assigned: Dec 29, 2005
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Suffolk Vascular Associates, PLLC Vascular Surgery Physician · Port Jefferson Station, NY · NPI 1720059926

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
178921-1	NY	MD	Anesthesiology Physician

Practice roles

Organization	Specialty	Status	New patients
Suffolk Vascular Associates, PLLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Anesthesiology Physician	207L00000X	178921-1	NY	Yes

Addresses

Primary practice location

333 Route 25a
Ste 225
Rocky Point, NY 11778-8802

Mailing address

333 Route 25a
Ste 225
Rocky Point, NY 11778-8802
Phone (631) 744-3671

Other identifiers

Identifier	Type	State	Issuer
01544187	Medicaid	NY

Other providers in Rocky Point, NY

All providers in Rocky Point, NY · Anesthesiology Physician in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.