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Provider Information for 1740626092


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Ms. EILEEN FUNG LPC


Sex: Female

NPI: 1740626092
Last Updated: 2023-11-04
Certification Date: 2023-11-04

Details

NameValue
NPI1740626092
Enumeration Date2013-05-14
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 332 TALL MEADOW LN
YARDLEY, PA 19067-6402
United States

Phone: 617-470-3719 | Fax:
 
Primary Practice Address 108 STRAUBE CENTER BLVD STE I8B
PENNINGTON, NJ 08534-1421
United States

Phone: 617-470-3719 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalNJ37PC00376200