Justin Dong, | |
13625 Maple Ave Ste 201, Flushing, NY 11355-3891 | |
(718) 886-8562 | |
Not Available |
Full Name | Justin Dong |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 13625 Maple Ave Ste 201, Flushing, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568166387 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Wensong Li Medicine Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1609085810 PECOS PAC ID: 8820195761 Enrollment ID: O20070529000511 |
Mailing Address | Practice Location Address |
---|---|
Justin Dong, 15446 26th Ave, Flushing, NY 11354-1518 Ph: (917) 885-3996 | Justin Dong, 13625 Maple Ave Ste 201, Flushing, NY 11355-3891 Ph: (718) 886-8562 |
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