Individual
BAI YAN GONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6819 FRESH POND RD, RIDGEWOOD, NY 11385-5240
(718) 456-4400
Mailing address
2719 44TH DR APT 16A, LONG ISLAND CITY, NY 11101-3052
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
072633-01
NY
Other
Enumeration date
08/07/2025
Last updated
08/08/2025
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