Individual
JACK FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 797-7940
Mailing address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 797-7940
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
026322
CT
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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