Provider Demographics
NPI:1215311386
Name:CHONG, JIA RONG (MD)
Entity type:Individual
Prefix:DR
First Name:JIA
Middle Name:RONG
Last Name:CHONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JARON
Other - Middle Name:JIA RONG
Other - Last Name:CHONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:360 STATE ST #2005
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510
Mailing Address - Country:US
Mailing Address - Phone:779-206-6678
Mailing Address - Fax:203-737-1688
Practice Address - Street 1:333 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-785-5253
Practice Address - Fax:203-737-1688
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT543352085B0100X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology