Individual
ALICE GONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 OAKWOOD RD, HUNTINGTON, NY 11743-4231
(718) 938-9557
Mailing address
138 FOREST DR, JERICHO, NY 11753-2323
(718) 938-9557
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
124750
NY
Other
Enumeration date
09/28/2024
Last updated
09/28/2024
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