Individual
DR. RICHARD W GONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263-3808
(716) 845-2300
Mailing address
601 ELMWOOD AVE BOX 648, ROCHESTER, NY 14642-8648
(585) 487-3308
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
256327
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04924338
—
NY
Enumeration date
08/01/2006
Last updated
01/12/2021
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