Chungdam Wellness Group,Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

254812 Issued in NY

Legal business name

CHUNGDAM WELLNESS GROUP,INC

Practice address

315 5TH Ave Ste 1001
New York, NY 10016-6510

Phone

(212) 685-1004

Fax

(212) 685-1007

NPI assigned

Oct 4, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lisa Persaud, M.D

Title

Medical Director

Phone

(212) 685-1004

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Young Jin Chang, D.P.T.

  • Physical Therapist
  • New York, NY
  • NPI 1780974543
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1730463183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 5TH AVE STE 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166510",
            "telephone_number": "212-685-1004",
            "fax_number": "212-685-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 5TH AVE STE 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166510",
            "telephone_number": "212-685-1004",
            "fax_number": "212-685-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUNGDAM WELLNESS GROUP,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "PERSAUD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-685-1004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "004553",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "032406",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "254812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilson Chung, D.O
• Wing Yee Chung, LCSW
• Yerin Chung
• Ying -Ying Chung, LMSW
• Chungdam Physical Therapy & Rehabilitation, P.C.
• Chungfai Tung M.D. P.C.
• Chunhua Acupuncture PC
• Nataliya Chupa, OTR/L
• Deveika Churaman, RN
• James M Church, M.D.

• Primary Care Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.