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General NPI Number Information
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NPI Number | 1154739324
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Entity Type | Organization
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Legal Business Name | JING GASTROENTEROLOGY & HEPATOLOGY PC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 13668 ROOSEVELT AVE FL 3
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City | FLUSHING
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State | NY
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Zip | 11354-5510
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Country | US
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Telephone | 718-886-9819
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Fax | 718-886-9809
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Provider Business Mailing Address
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Address Line | 15 OAK DR
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City | GREAT NECK
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State | NY
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Zip | 11021-1809
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Country | US
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Telephone | 516-472-7993
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Fax | 718-886-9809
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Authorized Official
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Title or Position | PRESIDENT
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Name | TONG JING
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Credential | MD
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Telephone | 718-886-9819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 256797
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 256797
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License Number State | NY
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