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Organization
REGINA FONG NP IN PSYCHIATRY, P.C.
Active
Organization
REGINA FONG NP IN PSYCHIATRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA FONG PMHNP (OWNER)
(631) 406-4056
Entity
Organization
Contact information
Practice address
88 TERRY RD, SMITHTOWN, NY 11787-3811
(631) 406-4056
Mailing address
88 TERRY RD, SMITHTOWN, NY 11787-3811
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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