MEDICARE: PRISCILLA CATHERINE TONG

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
1	1223G0001X	General Practice Dentistry	DN1858775	MA
2	390200000X	Student in an Organized Health Care Education/Training Program		NY
3	1223G0001X	General Practice Dentistry	061403	NY

General Provider Information

NPI Number	:	1447817382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA CATHERINE TONG

Provider Business Mailing Address
First Line	:	1808 CROTONA PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-1581
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1808 CROTONA PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-1581
Country	:	US
Telephone Number	:	888-833-8441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2019
Last Update Date	:	07/27/2022

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