1952306433 NPI number — DR. TUNG S CHEZ M.D. FACC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952306433 NPI number — DR. TUNG S CHEZ M.D. FACC

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CHEZ

Provider First Name:

TUNG

Provider Middle Name:

S

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D. FACC

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1952306433

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

08/24/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 690060

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

EAST ELMHURST

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11369-0060

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

212-740-0408

Provider Business Mailing Address Fax Number:

212-740-5300

Provider First Line Business Practice Location Address:

513 W 179TH ST

Provider Second Line Business Practice Location Address:

APT 1

Provider Business Practice Location Address City Name:

NEW YORK

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

10033-5708

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

212-740-0408

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

06/20/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RC0000X , with the licence number:  187002 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1024836 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 1000023248 . This is a "AFFINITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 2593560 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
• Identifier: 01382085 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 2815958013 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 08L953 . This is a "BCBS EMPIRE INDIVIDUAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 1534134 . This is a "UNITEDHEALTHCARE COMMERCI" identifier . This identifiers is of the category "OTHER".
• Identifier: 297228 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 4C4911 . This is a "HEALTHNET (PHS)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 187002 . This is a "HIP NEW YORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 2501740 . This is a "UNITEDHEALTHCARE GVT" identifier . This identifiers is of the category "OTHER".
• Identifier: 31C0691 . This is a "COMMUNITY PREMIER PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: NYIM172AC . This is a "CIGNA 2" identifier . This identifiers is of the category "OTHER".
• Identifier: P2046043 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".