Individual
RONALD FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W 168TH ST, PH 5-133, NEW YORK, NY 10032
(818) 657-9642
Mailing address
100 HAVEN AVE, APT 24C, NEW YORK, NY 10032-2645
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
100323
GA
207L00000X
Anesthesiology Physician
69334
WI
Other
Enumeration date
04/21/2014
Last updated
10/15/2024
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