Provider Demographics
NPI:1871910844
Name:RUNG, CAROLINE L (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:L
Last Name:RUNG
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MRS
Other - First Name:CAROLINE
Other - Middle Name:RUNG
Other - Last Name:ELSAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:7568 187TH ST
Mailing Address - Street 2:2ND FLR.
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1726
Mailing Address - Country:US
Mailing Address - Phone:718-670-1322
Mailing Address - Fax:718-661-7854
Practice Address - Street 1:7568 187TH ST
Practice Address - Street 2:2ND FLR.
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1726
Practice Address - Country:US
Practice Address - Phone:718-670-1322
Practice Address - Fax:718-661-7854
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16597170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS