Individual
JASON FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6134 188TH ST, SUITE 214, FRESH MEADOWS, NY 11365-2719
(718) 454-3200
(718) 454-4191
Mailing address
189-4 HILLSIDE AVE, HOLLIS, NY 11423
(718) 740-5545
(718) 740-1551
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
261057
NY
207V00000X
Obstetrics & Gynecology Physician
MD-16167
HI
Other
Enumeration date
07/18/2009
Last updated
12/15/2022
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