Provider Demographics
NPI:1588765168
Name:CHIN, SHUNG-FUNG (MS, RD, LDN)
Entity type:Individual
Prefix:MS
First Name:SHUNG-FUNG
Middle Name:
Last Name:CHIN
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-1455
Mailing Address - Country:US
Mailing Address - Phone:919-394-6255
Mailing Address - Fax:919-731-3394
Practice Address - Street 1:1103 LYNN DR
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-1455
Practice Address - Country:US
Practice Address - Phone:919-394-6255
Practice Address - Fax:919-731-3394
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000161133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered