Provider Demographics
NPI:1306498100
Name:CHUNG, CERRIS (PHARMD, BCACP)
Entity type:Individual
Prefix:
First Name:CERRIS
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TECHNOLOGY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-4710
Mailing Address - Country:US
Mailing Address - Phone:781-566-5066
Mailing Address - Fax:
Practice Address - Street 1:100 TECHNOLOGY CENTER DR
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4710
Practice Address - Country:US
Practice Address - Phone:781-566-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0645091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty