Individual
MR. RANDALL SCOTT GONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
737 WHALERS COVE PL, GALLOWAY, NJ 08205-3018
(609) 335-2033
Mailing address
737 WHALERS COVE PL, GALLOWAY, NJ 08205-3018
(609) 335-2033
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46T09167100
NJ
Other
Enumeration date
11/14/2020
Last updated
11/14/2020
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