Individual
HENRY FUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
244 W 54TH ST STE 614, NEW YORK, NY 10019-5515
(212) 757-3183
Mailing address
244 W 54TH ST STE 614, NEW YORK, NY 10019-5515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
060458-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2018
Last updated
10/09/2020
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