Provider Demographics
NPI:1982986634
Name:CHUN, SUNNY KYUNG (DO)
Entity type:Individual
Prefix:DR
First Name:SUNNY
Middle Name:KYUNG
Last Name:CHUN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FOREST AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5214
Mailing Address - Country:US
Mailing Address - Phone:201-879-0303
Mailing Address - Fax:201-880-6369
Practice Address - Street 1:4 FOREST AVE STE 205
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5214
Practice Address - Country:US
Practice Address - Phone:201-879-0303
Practice Address - Fax:201-880-6369
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09569900207NP0225X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04531173Medicaid
NY1982986634Medicaid