MEDICARE: KENNETH ONG 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
1	207RC0000X	Cardiovascular Disease Physician	158664	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922098284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH ONG MD

Provider Business Mailing Address
First Line	:	69 CAFFREY AVE
Second Line	:
City	:	BETHPAGE
State	:	NY
Zip	:	11714-1436
Country	:	US
Telephone Number	:	516-281-5037
Fax Number	:	718-579-5137

Provider Business Practice Location Address
First Line	:	234 E 149TH ST
Second Line	:	LINCOLN MEDICAL CENTER, 7C-172
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5000
Fax Number	:	718-579-5137

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	01/06/2016

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