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NPI Code Detail

MEDICARE: WING TAI KONG MD

MEDICARE: WING TAI KONG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician282716MA
2207RP1001XPulmonary Disease Physician25MA12885800NJ

General Provider Information

NPI Number : 1346669355
Entity Type Code : Individual
Provider Name (Legal Business Name) : WING TAI KONG MD
Provider Business Mailing Address
First Line : 1529 83RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-3129
Country : US
Telephone Number : 917-378-1882
Fax Number :
Provider Business Practice Location Address
First Line : 2799 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48202-2608
Country : US
Telephone Number : 313-916-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2014
Last Update Date : 01/26/2026

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Directions to “ WING TAI KONG MD” Practice Location

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