Provider Demographics
NPI:1063720837
Name:CHUN, YOUNG J
Entity type:Individual
Prefix:
First Name:YOUNG
Middle Name:J
Last Name:CHUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 HALEDON AVE
Mailing Address - Street 2:
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1555
Mailing Address - Country:US
Mailing Address - Phone:973-904-0550
Mailing Address - Fax:
Practice Address - Street 1:431 HALEDON AVE
Practice Address - Street 2:
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-1555
Practice Address - Country:US
Practice Address - Phone:973-904-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03096600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist