Provider Demographics
NPI:1285875484
Name:JUNG, THOMAS SUNJIN (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:SUNJIN
Last Name:JUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CEDAR STREET
Mailing Address - Street 2:LMP 1080
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-4138
Mailing Address - Fax:
Practice Address - Street 1:129 YORK ST
Practice Address - Street 2:3H
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5608
Practice Address - Country:US
Practice Address - Phone:203-785-4138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047422207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine