Provider Demographics
NPI:1144340225
Name:JUNG, ANTHONY HIGUK (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:HIGUK
Last Name:JUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HI
Other - Middle Name:GUK
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:40-18 MURRAY STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4934
Mailing Address - Country:US
Mailing Address - Phone:718-461-6464
Mailing Address - Fax:718-939-6464
Practice Address - Street 1:40-18MURRAY STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4934
Practice Address - Country:US
Practice Address - Phone:718-461-6464
Practice Address - Fax:718-939-6464
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182552207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01309282Medicaid
NYG400008136OtherMEDICARE PTAN