Provider Demographics
NPI:1528269107
Name:FUNG, CHRISTINE (RD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:FUNG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:FUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:217 ANN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5105
Mailing Address - Country:US
Mailing Address - Phone:908-229-5436
Mailing Address - Fax:908-904-0436
Practice Address - Street 1:123 DUNHAMS CORNER RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3500
Practice Address - Country:US
Practice Address - Phone:732-254-0113
Practice Address - Fax:732-254-2277
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered