Provider Demographics
NPI:1376672410
Name:SHIWEI TONG, M.D., LLC
Entity Type:Organization
Organization Name:SHIWEI TONG, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIWEI
Authorized Official - Middle Name:
Authorized Official - Last Name:TONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-275-6810
Mailing Address - Street 1:666 PLAINSBORO RD STE 1005
Mailing Address - Street 2:BLDG. 1000
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3013
Mailing Address - Country:US
Mailing Address - Phone:609-275-6810
Mailing Address - Fax:609-275-8862
Practice Address - Street 1:666 PLAINSBORO RD STE 1005
Practice Address - Street 2:BLDG. 1000
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3013
Practice Address - Country:US
Practice Address - Phone:609-275-6810
Practice Address - Fax:609-275-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA074825208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA074825OtherLIICENSE NO