Individual
DR. JERRY TSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
046608
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046608
LICENSE
CT
01
—
046608
CONNECTICARE
—
01
—
243110
MEDICAL LICENSE
NY
01
—
25MA08270400
MEDICAL LICENSE
NJ
01
—
3V2537
HEALTHNET
—
01
—
663340
AETNA
—
01
—
A95703
LICENSE
CA
Enumeration date
07/04/2006
Last updated
07/02/2010
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