Basic Information
Provider Information
NPI: 1831309574
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHUNG
FirstName: JIYON
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 41 EAST POST ROAD
Address2: WHITE PLAINS HOSPITAL
City: WHITE PLAINS
State: NY
PostalCode: 10601
CountryCode: US
TelephoneNumber: 9146812560
FaxNumber: 9146812590
Practice Location
Address1: 41 EAST POST ROAD
Address2: WHITE PLAINS HOSPITAL
City: WHITE PLAINS
State: NY
PostalCode: 10601
CountryCode: US
TelephoneNumber: 9146812560
FaxNumber: 9146812590
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 10/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X253514NYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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