Provider Demographics
NPI:1407810468
Name:TONG, SHIWEI (MD)
Entity Type:Individual
Prefix:
First Name:SHIWEI
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6516
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-6516
Mailing Address - Country:US
Mailing Address - Phone:609-275-6810
Mailing Address - Fax:609-275-8862
Practice Address - Street 1:829 57TH ST UNIT 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3677
Practice Address - Country:US
Practice Address - Phone:718-438-2988
Practice Address - Fax:718-438-2588
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213711208000000X
NJ25MA07482500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01984523Medicaid