Provider Demographics
NPI:1215263975
Name:LUNG, JENNIFER YU-LAN (DPT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:YU-LAN
Last Name:LUNG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:YU-LAN
Other - Last Name:LUNG-BUGENSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT, SCS
Mailing Address - Street 1:130 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-1727
Mailing Address - Country:US
Mailing Address - Phone:914-273-3413
Mailing Address - Fax:914-273-3036
Practice Address - Street 1:130 BUSINESS PARK DR
Practice Address - Street 2:SUITE 5
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-1727
Practice Address - Country:US
Practice Address - Phone:914-273-3413
Practice Address - Fax:914-273-3036
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030537-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist