Provider Demographics
NPI:1265822654
Name:XIANG BIN KONG MEDICAL PC
Entity Type:Organization
Organization Name:XIANG BIN KONG MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:XIANGBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-902-2785
Mailing Address - Street 1:19305 MCLAUGHLIN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1147
Mailing Address - Country:US
Mailing Address - Phone:917-902-2785
Mailing Address - Fax:718-686-6561
Practice Address - Street 1:835 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4310
Practice Address - Country:US
Practice Address - Phone:718-686-6548
Practice Address - Fax:718-686-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty