Provider Demographics
NPI:1194887281
Name:HE, CONG (MD)
Entity type:Individual
Prefix:
First Name:CONG
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13338 41ST RD
Mailing Address - Street 2:SUITE 2N
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3782
Mailing Address - Country:US
Mailing Address - Phone:718-939-5200
Mailing Address - Fax:718-939-5210
Practice Address - Street 1:13338 41ST RD
Practice Address - Street 2:SUITE 2N
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3782
Practice Address - Country:US
Practice Address - Phone:718-939-5200
Practice Address - Fax:718-939-5210
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY201494207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG400012918Medicare PIN