Healthcare Provider Details

I. General information

NPI: 1720072242
Provider Name (Legal Business Name): ROLANDO Y HONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 RAYMOND BLVD
NEWARK NJ
07102-4199
US

IV. Provider business mailing address

66 WEST GILBERT STREET
RED BANK NJ
07701-4918
US

V. Phone/Fax

Practice location:
  • Phone: 973-596-3857
  • Fax:
Mailing address:
  • Phone: 732-212-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number25MA05657400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA05657400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: