Provider Demographics
NPI:1619076833
Name:GONG, YUHONG (MD)
Entity Type:Individual
Prefix:
First Name:YUHONG
Middle Name:
Last Name:GONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MAIN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1969
Mailing Address - Country:US
Mailing Address - Phone:978-687-0481
Mailing Address - Fax:978-725-2505
Practice Address - Street 1:60 EAST ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4500
Practice Address - Country:US
Practice Address - Phone:978-687-0481
Practice Address - Fax:978-725-2505
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT57107207RE0101X, 207R00000X
MA229275207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism