Chung, Chung-Taik

Chung, Chung-Taik is an individual health care provider with primary practice located at 750 E Adams St , Syracuse NY 13210-2306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Chung, Chung-Taik can be contacted via phone (315) 464-5276.

Contact Information

Primary practice address
750 E Adams St Syracuse NY 13210-2306
Phone: (315) 464-5276
Fax: (315) 464-5939
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 119070 New York

Profile Details

NPI number 1770506412
LBN Legal business name Chung, Chung-Taik
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Dec 16th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770506412 NPPES
New York Other 119070 NYS LICENSE
New York MEDICAID 00470195 NYS LICENSE

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