Individual
DAISY FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3133 E MAIN ST, MOHEGAN LAKE, NY 10547-1521
(914) 526-1105
Mailing address
147 OLD FARM RD S, PLEASANTVILLE, NY 10570-1507
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
032876
NY
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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