Provider Demographics
NPI:1962514786
Name:SUNG, JIN WOO (DC)
Entity type:Individual
Prefix:DR
First Name:JIN
Middle Name:WOO
Last Name:SUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6109
Mailing Address - Country:US
Mailing Address - Phone:978-688-6999
Mailing Address - Fax:978-688-4747
Practice Address - Street 1:126 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6109
Practice Address - Country:US
Practice Address - Phone:978-688-6999
Practice Address - Fax:978-688-4747
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA42313OtherHARVARD PILGRIM
642213OtherTUFTS HEALTH
Y37024OtherBCBS OF MA
606411OtherUNITED HEALTHCARE
1071611OtherAETNA
642213OtherTUFTS HEALTH