Healthcare Provider Details

I. General information

NPI: 1760437636
Provider Name (Legal Business Name): KAB S. HONG, MD. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 W CHELTENHAM AVE SUITE 201
ELKINS PARK PA
19027-3141
US

IV. Provider business mailing address

1349 W CHELTENHAM AVE STE 201
ELKINS PARK PA
19027-3141
US

V. Phone/Fax

Practice location:
  • Phone: 215-782-1610
  • Fax: 215-782-1620
Mailing address:
  • Phone: 215-782-1610
  • Fax: 215-782-1620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberMD039474L
License Number StatePA

VIII. Authorized Official

Name: DR. KAB S HONG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 215-782-1610