Individual
FANYI KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2811 208TH ST, BAYSIDE, NY 11360-2420
(917) 655-4693
Mailing address
2811 208TH ST, BAYSIDE, NY 11360-2420
(917) 655-4693
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
223594
NY
Other
Enumeration date
11/16/2006
Last updated
04/10/2013
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