Organization
REGINA FONG NP IN PSYCHIATRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA FONG PMHNP (OWNER)
(631) 406-4056
Entity
Organization
Contact information
Practice address
88 TERRY RD, SMITHTOWN, NY 11787-3811
(631) 406-4056
Mailing address
88 TERRY RD, SMITHTOWN, NY 11787-3811
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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