Dr Chung Medical Clinic P C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA5927500 Issued in NJ

Legal business name

DR CHUNG MEDICAL CLINIC P C

Practice address

11 E Harwood Ter
Palisades Park, NJ 07650-1424

Phone

(201) 313-1500

Fax

(201) 941-4157

NPI assigned

Jul 9, 2008

Last updated

Jul 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Haeyang Chung, M.D.NPI 1285670059

Title

President

Phone

(201) 313-1500

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Haeyang Chung, M.D.

  • Internal Medicine Physician
  • Palisades Park, NJ
  • NPI 1285670059
  Medicare reassignment NPD Authorized official
• Jenny Jee Young Hong, APN

  • Adult Health Nurse Practitioner
  • Englewood Cliffs, NJ
  • NPI 1215342696
  Medicare reassignment NPD
• Richard Hong Ki Joo, MD

  • Internal Medicine Physician
  • Englewood Cliffs, NJ
  • NPI 1851351282
  NPD (past)
• Geeeun Kim, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Tenafly, NJ
  • NPI 1598006553
  NPD (past)
• Soonhee Pieh, NP

  • Family Nurse Practitioner
  • Palisades Park, NJ
  • NPI 1952852394
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1902069925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 E HARWOOD TER",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501424",
            "telephone_number": "201-313-1500",
            "fax_number": "201-941-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E HARWOOD TER",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501424",
            "telephone_number": "201-313-1500",
            "fax_number": "201-941-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CHUNG MEDICAL CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "HAEYANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-313-1500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA5927500",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA5927500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.