Provider Demographics
NPI:1619185782
Name:JONG, HO-YEONG
Entity Type:Individual
Prefix:
First Name:HO-YEONG
Middle Name:
Last Name:JONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ASHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2321
Mailing Address - Country:US
Mailing Address - Phone:917-254-1300
Mailing Address - Fax:
Practice Address - Street 1:18 ASHWOOD CT
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-2321
Practice Address - Country:US
Practice Address - Phone:917-254-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral