Alexander Gong, DPT | |
102 Irving St Nw, Washington, DC 20010-2921 | |
(202) 877-1000 | |
Not Available |
Full Name | Alexander Gong |
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Gender | Male |
Speciality | Physical Therapist - Orthopedic |
Location | 102 Irving St Nw, Washington, District Of Columbia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851173421 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251X0800X | Physical Therapist - Orthopedic | 40QA02118200 (New Jersey) | Secondary |
2251X0800X | Physical Therapist - Orthopedic | 210002401 (District Of Columbia) | Primary |
Provider Name | Ivyrehab Connecticut Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1265799365 PECOS PAC ID: 8325203649 Enrollment ID: O20120711000223 |
Mailing Address | Practice Location Address |
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Alexander Gong, DPT 444 Poplar Ave, Galloway, NJ 08205-4513 Ph: (609) 350-9257 | Alexander Gong, DPT 102 Irving St Nw, Washington, DC 20010-2921 Ph: (202) 877-1000 |
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