Individual ProviderJung Hwa PaikNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2015 Grand Concourse, Bronx, NY 10453(718) 299-7295(718) 618-0401PECOS EnrollmentBased on the most recent information from CMS, provider Jung Hwa Paik is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1588155840Provider TypeIndividualFull NamePaik, Jung HwaCredentialFNPGenderFemaleSole ProprietorYesEnumeration Date5/22/2018Last Updated12/11/2018Contact InformationPractice LocationPractice Address2015 Grand Concourse, Bronx, NY 10453Phone(718) 299-7295FaxUnlisted FaxMailing LocationMailing Address3198 Grand Concourse, Bronx, NY 10458-1000Phone(718) 618-0401FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF339550New York