Healthcare Provider Details

I. General information

NPI: 1659812881
Provider Name (Legal Business Name): EMILY ELIZABETH TONGDEE MD, FAAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LIVINGSTON ST # 3L
BROOKLYN NY
11201-5127
US

IV. Provider business mailing address

100 LIVINGSTON ST # 3L
BROOKLYN NY
11201-5127
US

V. Phone/Fax

Practice location:
  • Phone: 347-797-5005
  • Fax:
Mailing address:
  • Phone: 347-797-5005
  • Fax: 347-212-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number295430
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: