DR. CHUNG K SHIN (NPI# 1386791143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386791143 |
| Entity Type | Individual |
| Full Name | DR. CHUNG K SHIN |
| Credential | M.D. |
| Practice Address |
91 East Ave Norwalk CT 06851-5020 |
| Practice Telephone | 2038559806 |
| Practice Fax Number | 2038551135 |
| Mailing Telephone | 2038559806 |
| Mailing Fax Number | 2038551135 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 037720 | CT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | AETNA | 2322912 | 01 |
| CT | BLUE CROSS | 01377200CT03 | 01 |
| CT | CIGNA | 3324246-004 | 01 |
| CT | HEALTHNET | 0V7050 | 01 |
| CT | WELLCARE | 178311 | 01 |
| CT | CONNECTICARE | 037720 | 01 |
| CT | OXFORD | P2061278 | 01 |
| Street Address |
91 EAST AVE |
| City | NORWALK |
| State | CT |
| Zip Code | 06851-5020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609872225 | Frances Becker | Social Worker | 91 East Ave, Norwalk, CT 06851-5020 | 2005-06-28 |
| 1871191858 | Three Little Birds, LLC | Social Worker | 91 East Ave, Norwalk, CT 06851-5020 | 2020-10-13 |
| 1124648910 | Phianh Waldon | Dentist | 91 East Ave, Norwalk, CT 06851-5020 | 2020-04-21 |
| 1568096477 | Alexander Loeb | Dentist | 91 East Ave, Norwalk, CT 06851-5020 | 2020-02-29 |
| 1548733181 | Mbs Counseling, LLC | Social Worker | 91 East Ave, Norwalk, CT 06851-5020 | 2019-01-07 |
| 1972015907 | Theresa Maria Roth | Social Worker | 91 East Ave, Norwalk, CT 06851-5020 | 2017-10-31 |
| 1922535921 | Pimputkar LLC | Clinic/Center | 91 East Ave, Norwalk, CT 06851-5020 | 2017-05-22 |
| 1134581481 | Gentle Rock Therapy LLC | Community/Behavioral Health | 91 East Ave, Norwalk, CT 06851-5020 | 2016-03-25 |
| 1457713703 | Elizabeth Gentile | Social Worker | 91 East Ave, Norwalk, CT 06851-5020 | 2016-03-25 |
| 1285008177 | Jamie Ahn | Naturopath | 91 East Ave, Garden Suite, Norwalk, CT 06851-5020 | 2015-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144763434 | Cynthia Eliezer | Student in an Organized Health Care Education/Training Program | 120 East Ave 2nd Flr., Norwalk, CT 06851 | 2016-11-18 |
| 1356897672 | Be Balanced Naturopathic Care Center, LLC | Naturopath | 91 East Ave, Garden Level, Norwalk, CT 06851 | 2016-08-28 |
| 1861843559 | Valerie Andree Vincent | Student in an Organized Health Care Education/Training Program | 120 East Avenue-2nd Floor, Catholic Charities, Norwalk, CT 06851 | 2016-06-24 |
| 1417333758 | Laura Rebecca Nierenberg Fishman | Marriage & Family Therapist | 161 East Avenue, Suite 101, Norwalk, CT 06851 | 2015-08-10 |
| 1487085411 | Danielle Christine Boland | Social Worker | 206 Wolfpit Avenue, Norwalk, CT 06851 | 2013-12-02 |
| 1427485846 | Michelle Clement | Technician/Technologist | 650 Main Avenue, Norwalk, CT 06851 | 2013-09-30 |
| 1932447430 | Rebecca Roessler Velasquez | Social Worker | 225 W Rocks Rd, Norwalk, CT 06851 | 2013-01-18 |
| 1275809154 | Tiffany A. Mccarty | Social Worker | 166 East Ave Ste 204, Norwalk, CT 06851 | 2012-03-26 |
| 1356573547 | Cheree Louise Fenske | Clinical Neuropsychologist | 761 Main Ave Ste 104, Norwalk, CT 06851 | 2009-08-20 |
| 1083869572 | Carol Lynne Cooper | Obstetrics & Gynecology | 17 North Ave., Norwalk, CT 06851 | 2008-11-25 |
| Find all providers in zip 06851 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962937086 | Karen Marie Fogler | Specialist | 50 Washington St Ste 502, Norwalk, CT 06854-2755 | 2017-04-26 |
| 1548620586 | Jessika Quiroga | Specialist | 11144 Excelsior Dr, Apt.6, Norwalk, CA 90650-5680 | 2016-03-03 |
| 1528446960 | Esmeralda Mencias | Specialist | 14402 Leibacher Ave, Norwalk, CA 90650-4646 | 2015-05-18 |
| 1710399571 | Monica Powers | Specialist | 16 Gerard Dr, Norwalk, OH 44857-2497 | 2014-05-28 |
| 1558608471 | Karen Lin Moll | Specialist | 4 Fairfield Ave, Apt 1, Norwalk, CT 06854-2153 | 2013-01-11 |
| 1326399551 | Emily Schernau | Specialist | 1 Daskams Ln, Apt 3c, Norwalk, CT 06851-4843 | 2012-09-27 |
| 1306194642 | Diane Beth Weiss | Specialist | 12 Rae Lane, Norwalk, CT 06850 | 2012-08-16 |
| 1245591346 | Zhandra Camacho | Specialist | 5 Van Zant St, Unit 2, Norwalk, CT 06855-1717 | 2012-06-05 |
| 1063787786 | Skin Cancer Center of Fairfield County PC | Specialist | 148 East Ave Ste 3b, Norwalk, CT 06851-5726 | 2012-03-13 |
| 1154630036 | Megan D Dodge | Specialist | 164 Milan Ave, Norwalk, OH 44857-1146 | 2010-09-27 |
| Find all providers in NORWALK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.