Provider Demographics
NPI:1396805172
Name:CHUNG, HYUNWOO (MD)
Entity type:Individual
Prefix:DR
First Name:HYUNWOO
Middle Name:
Last Name:CHUNG
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 1:511 HOMANS AVE
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-2906
Mailing Address - Country:US
Mailing Address - Phone:646-321-4788
Mailing Address - Fax:
Practice Address - Street 1:9745 63RD DR
Practice Address - Street 2:FL 1
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2229
Practice Address - Country:US
Practice Address - Phone:718-544-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225794208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)