Provider Demographics
NPI:1932598653
Name:FONG, CAI YU
Entity type:Individual
Prefix:
First Name:CAI YU
Middle Name:
Last Name:FONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7220 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-1908
Practice Address - Country:US
Practice Address - Phone:917-549-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY694926163W00000X, 163WC0400X, 163WC3500X, 163WD1100X, 163WG0000X, 163WH0200X, 163WM0102X, 163WM0705X, 163WN1003X, 163WP0808X, 163WP2201X, 163WR0400X, 163WS0121X, 163WW0101X
NY694926N163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory