Individual ProviderJae K ChungStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address47 New Scotland Avenue, Dept. Of Internal Medicine, Albany, NY 12208(518) 262-5377PECOS EnrollmentThis provider is enrolled in PECOS as JAE CHUNG.Based on the most recent information from CMS, provider Jae K Chung is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1265937965Provider TypeIndividualFull NameChung, Jae KCredentialDOGenderMaleSole ProprietorNoEnumeration Date3/26/2018Last Updated3/27/2018Contact InformationPractice LocationPractice Address47 New Scotland Avenue, Dept. Of Internal Medicine, Albany, NY 12208Phone(518) 262-5377FaxUnlisted FaxMailing LocationMailing Address47 New Scotland Avenue, Dept. Of Internal Medicine, Albany, NY 12208PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense64004