Healthcare Provider Details

I. General information

NPI: 1205253952
Provider Name (Legal Business Name): SARON FONG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 ROUTE 211 E
MIDDLETOWN NY
10940-3109
US

IV. Provider business mailing address

126 NEW VERNON RD STE 1
HOWELLS NY
10932-9800
US

V. Phone/Fax

Practice location:
  • Phone: 845-500-6330
  • Fax: 845-386-9979
Mailing address:
  • Phone: 845-500-6330
  • Fax: 845-386-9979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR264352
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402476
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: