Provider Demographics
NPI:1316916778
Name:JING, TONG (MD)
Entity type:Individual
Prefix:
First Name:TONG
Middle Name:
Last Name:JING
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 1:13668 ROOSEVELT AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5510
Mailing Address - Country:US
Mailing Address - Phone:718-886-9819
Mailing Address - Fax:718-886-9809
Practice Address - Street 1:13668 ROOSEVELT AVE
Practice Address - Street 2:FL 3
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5510
Practice Address - Country:US
Practice Address - Phone:718-886-9819
Practice Address - Fax:718-886-9809
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO44222207RG0100X
NY256797207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I41516Medicare UPIN