Provider Demographics
NPI:1730347212
Name:FUNG, KENT C (MD)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:C
Last Name:FUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:985 CEDAR BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4167
Mailing Address - Country:US
Mailing Address - Phone:732-477-5600
Mailing Address - Fax:732-477-1899
Practice Address - Street 1:985 CEDAR BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4167
Practice Address - Country:US
Practice Address - Phone:732-477-5600
Practice Address - Fax:732-477-1899
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT191538207Q00000X
NJ25MA08678600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine