Individual
DIANA HYEJUNG KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
120 MINEOLA BLVD, SUITE 210, MINEOLA, NY 11501-4064
(516) 663-4600
(516) 663-3826
Mailing address
222 STATION PLZ N, SUITE 611, MINEOLA, NY 11501-3800
(516) 663-2532
(516) 663-2233
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381261
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02160089
—
NY
Enumeration date
09/13/2005
Last updated
02/14/2012
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