Individual
JENNIFER FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
622 W 168TH ST PH 5-133, NEW YORK, NY 10032-3720
(212) 305-3226
Mailing address
6921 173RD ST, FRESH MEADOWS, NY 11365-3432
(917) 547-7051
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
305045
NY
Other
Enumeration date
03/27/2018
Last updated
06/23/2022
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