Provider Demographics
NPI:1649489758
Name:CHUNG, HOIWING THERESA (DPT)
Entity type:Individual
Prefix:
First Name:HOIWING
Middle Name:THERESA
Last Name:CHUNG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HOIWING
Other - Middle Name:THERESA
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:20362 CLIFTONS POINT ST
Mailing Address - Street 2:
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-3121
Mailing Address - Country:US
Mailing Address - Phone:917-923-8069
Mailing Address - Fax:571-643-0336
Practice Address - Street 1:1800 CAMERON GLEN DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3308
Practice Address - Country:US
Practice Address - Phone:703-834-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027469225100000X
VA2305206333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist