MEDICARE: MOLLY TONG 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
1	183500000X	Pharmacist	046624	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881831675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY TONG RPH

Provider Business Mailing Address
First Line	:	11449 SUTPHIN BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-1022
Country	:	US
Telephone Number	:	718-848-4900
Fax Number	:	718-848-4903

Provider Business Practice Location Address
First Line	:	11449 SUTPHIN BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-1022
Country	:	US
Telephone Number	:	718-848-4900
Fax Number	:	718-848-4903

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

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	05/06/2010

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Directions to “ MOLLY TONG RPH” Practice Location

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