Physician Compare National (NPI:1598304370)

HEALTHCARE PROVIDER: JENNA KONG RDN

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598304370
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951737253
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200205001178
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KONG
	Individual professional last name
Provider First Name	JENNA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	943 B VILLAGE DR W
	Group Practice or individual's line 1 address
City	NORTH BRUNSWICK
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	089022825
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y