Individual
JACOB TIONG GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-1033
(516) 437-4167
Mailing address
PO BOX 27842, NEW YORK, NY 10087-7842
(718) 670-1651
(516) 437-4167
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
202137
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02231872
—
NY
Enumeration date
06/15/2006
Last updated
06/05/2023
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