Provider Demographics
NPI:1497198253
Name:DONG, JUSTINE (MS)
Entity Type:Individual
Prefix:MISS
First Name:JUSTINE
Middle Name:
Last Name:DONG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5028
Mailing Address - Country:US
Mailing Address - Phone:718-743-9713
Mailing Address - Fax:
Practice Address - Street 1:2338 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5028
Practice Address - Country:US
Practice Address - Phone:718-743-9713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist