Healthcare Provider Details

I. General information

NPI: 1578695862
Provider Name (Legal Business Name): GABRIEL TSING-TZONG CHONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 09/11/2025
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 BLUE RIDGE RD SUITE 100
RALEIGH NC
27607-6462
US

IV. Provider business mailing address

2709 BLUE RIDGE RD SUITE 100
RALEIGH NC
27607-6462
US

V. Phone/Fax

Practice location:
  • Phone: 614-370-7837
  • Fax:
Mailing address:
  • Phone: 614-370-7837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number201100497
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: