Provider Demographics
NPI:1730368747
Name:CHUNG, ROBERT YOUNG-JU (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:YOUNG-JU
Last Name:CHUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 UNION AVE
Mailing Address - Street 2:RTE 300
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1633
Mailing Address - Country:US
Mailing Address - Phone:845-567-6093
Mailing Address - Fax:845-567-6245
Practice Address - Street 1:1201 UNION AVE
Practice Address - Street 2:RTE 300
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1633
Practice Address - Country:US
Practice Address - Phone:845-567-6093
Practice Address - Fax:845-567-6245
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist