Provider Demographics
NPI:1730761792
Name:CHUN, MARTIN (LICENSED SOCIAL WORK)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:
Last Name:CHUN
Suffix:
Gender:M
Credentials:LICENSED SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 LAKEVIEW TER
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5727
Mailing Address - Country:US
Mailing Address - Phone:908-578-6607
Mailing Address - Fax:
Practice Address - Street 1:1225 WHITEHORSE MERCERVILLE RD BLDG B
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3882
Practice Address - Country:US
Practice Address - Phone:609-256-4200
Practice Address - Fax:609-581-1623
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05925900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker