Healthcare Provider Details

I. General information

NPI: 1366373268
Provider Name (Legal Business Name): EILEEN M TONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 5TH AVE RM 903A
NEW YORK NY
10011-7611
US

IV. Provider business mailing address

117 N 15TH ST APT 504
PHILADELPHIA PA
19102-1517
US

V. Phone/Fax

Practice location:
  • Phone: 646-389-2866
  • Fax:
Mailing address:
  • Phone: 973-885-4272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: