Individual
KEMOY FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2698
(973) 761-6111
(973) 761-6111
Mailing address
2620 W LAKEWOOD LN APT 3B, OAK CREEK, WI 53154-8230
(407) 616-3976
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11742-33
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ14897500
NJ
Other
Enumeration date
04/30/2022
Last updated
10/16/2024
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