Individual
MR. JERRY KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
501 IRON BRIDGE RD, SUITE 1, FREEHOLD, NJ 07728-5304
(732) 720-2565
(732) 720-2556
Mailing address
501 IRON BRIDGE RD, SUITE 1, FREEHOLD, NJ 07728-5304
(732) 720-2565
(732) 720-2556
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00133300
NJ
363AS0400X
Surgical Physician Assistant
25MP00133300
NJ
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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