Healthcare Provider Details

I. General information

NPI: 1992745301
Provider Name (Legal Business Name): JOSE RAMON C ONGKINGCO MD, FAAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 MANHATTAN SQ
HAMPTON VA
23666-5843
US

IV. Provider business mailing address

23 MANHATTAN SQ
HAMPTON VA
23666-5843
US

V. Phone/Fax

Practice location:
  • Phone: 757-224-1600
  • Fax: 757-825-1316
Mailing address:
  • Phone: 757-224-1600
  • Fax: 757-825-1316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101049781
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: