Provider Demographics
NPI:1528235793
Name:TONG, HERMAN (PA)
Entity type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25 RUSTIC GATE LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6136
Mailing Address - Country:US
Mailing Address - Phone:516-662-1622
Mailing Address - Fax:
Practice Address - Street 1:656 NORTH WELLWOOD AVENUE
Practice Address - Street 2:CITYMD
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757
Practice Address - Country:US
Practice Address - Phone:631-225-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018290363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant