Timothy Chung

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

10303087 Issued in NY

Practice address

21955 67TH Ave
Bayside, NY 11364-2638

Phone

(917) 238-8129

NPI assigned

Aug 12, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1881973402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21955 67TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113642638",
            "telephone_number": "917-238-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21955 67TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113642638",
            "telephone_number": "917-238-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10303087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary S Chubak, M.D.
• Hee Eun Chun
• Soo Ah Chun
• Justin Jongkyu Chung
• Sojin Chung, L.AC
• Thomas Michael Cipriano
• Amy Marie Cirrincione, TSSH BS,MS
• City Medical of Upper East Side, PLLC
• City Medical of Upper East Side, PLLC
• City PT Services PLLC

• Licensed Practical Nurse in Bayside, NY
• Providers in Bayside, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.