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NPI Code Detail

MEDICARE: ADELAIDE GONG RPH

MEDICARE: ADELAIDE GONG RPH
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
1183500000XPharmacist043359NY

General Provider Information

NPI Number : 1518289883
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELAIDE GONG RPH
Provider Business Mailing Address
First Line : 750 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-2910
Country : US
Telephone Number : 718-383-7967
Fax Number : 718-389-2569
Provider Business Practice Location Address
First Line : 750 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-2910
Country : US
Telephone Number : 718-383-7967
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2010
Last Update Date : 07/20/2024

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Directions to “ ADELAIDE GONG RPH” Practice Location

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