Individual
MS. VIDA JONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
292 MADISON AVE, 2ND FLOOR, NEW YORK, NY 10017-6307
(212) 418-0321
Mailing address
327 E 34TH ST, APT. 2D, NEW YORK, NY 10016-4943
(917) 309-0417
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
019406-1
NY
Other
Enumeration date
04/22/2009
Last updated
08/30/2011
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