MEDICARE: TELONG TONEY

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	164W00000X	Licensed Practical Nurse	323338-1	NY

General Provider Information

NPI Number	:	1578938155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TELONG TONEY

Provider Business Mailing Address
First Line	:	76 HIGHVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-1317
Country	:	US
Telephone Number	:	917-284-5596
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 HIGHVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-1317
Country	:	US
Telephone Number	:	917-284-5596
Fax Number	:

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

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	12/07/2015

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Directions to “ TELONG TONEY ” Practice Location

Language	Start Address	Practice Location

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