Individual
DR. AMANDA W PONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
50 FOREST ST, APT 1421, STAMFORD, CT 06901
(619) 322-2577
Mailing address
50 FOREST ST, APT 1421, STAMFORD, CT 06901
(619) 322-2577
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
249659
NY
Other
Enumeration date
06/05/2007
Last updated
08/15/2008
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