Provider Demographics
NPI:1174242275
Name:CHUNG, SUK-LING
Entity type:Individual
Prefix:
First Name:SUK-LING
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 BROADFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:MAPLE GLEN
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3134
Mailing Address - Country:US
Mailing Address - Phone:215-628-9094
Mailing Address - Fax:215-628-3363
Practice Address - Street 1:3900 FORD RD APT 20B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2037
Practice Address - Country:US
Practice Address - Phone:215-986-5111
Practice Address - Fax:215-628-3363
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT3848L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist