Basic Information
| Provider Information | |||||||||
| NPI: | 1285875484 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUNG | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | SUNJIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 CEDAR STREET | ||||||||
| Address2: | LMP 1080 | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037854138 | ||||||||
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| Practice Location | |||||||||
| Address1: | 129 YORK ST | ||||||||
| Address2: | 3H | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065115608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037854138 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2009 | ||||||||
| LastUpdateDate: | 11/03/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 047422 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 047422 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.