Provider Demographics
NPI:1720207400
Name:TONG, PATRICK-JAMES MAHER (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK-JAMES
Middle Name:MAHER
Last Name:TONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PATRICK-JAMES
Other - Middle Name:
Other - Last Name:MAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:47 W 89TH ST
Mailing Address - Street 2:2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2023
Mailing Address - Country:US
Mailing Address - Phone:212-595-1341
Mailing Address - Fax:
Practice Address - Street 1:47 W 89TH ST
Practice Address - Street 2:2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2023
Practice Address - Country:US
Practice Address - Phone:212-595-1341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP0405207P00000X
NY187952207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF42373Medicare UPIN