Healthcare Provider Details

I. General information

NPI: 1497199228
Provider Name (Legal Business Name): RONALD CHONG-YIK MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVENUE #679
ROCHESTER NY
14642
US

IV. Provider business mailing address

601 ELM AVENUE BOX 679
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-7800
  • Fax: 585-341-4213
Mailing address:
  • Phone: 585-341-7800
  • Fax: 585-341-4213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12219665-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number29796801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: