Individual
CARISSA KAWENA FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2811 QUEENS PLZ N, LONG ISLAND CITY, NY 11101-4172
(718) 391-8300
Mailing address
4540 CENTER BLVD APT 2108, LONG ISLAND CITY, NY 11109-5810
(925) 963-4596
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
922657
NY
Other
Enumeration date
01/26/2026
Last updated
01/26/2026
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