Healthcare Provider Details

I. General information

NPI: 1518499284
Provider Name (Legal Business Name): JASON KAY CHONG TONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST 4 MALONEY
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

V. Phone/Fax

Practice location:
  • Phone: 212-662-6156
  • Fax:
Mailing address:
  • Phone: 215-600-5107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD469279
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: