Provider Demographics
NPI:1649017252
Name:MONG, ALEX (MSCPT)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:MONG
Suffix:
Gender:M
Credentials:MSCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BELDEN AVE UNIT 1208
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3364
Mailing Address - Country:US
Mailing Address - Phone:519-903-3178
Mailing Address - Fax:
Practice Address - Street 1:282 RAILROAD AVE # 100
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6375
Practice Address - Country:US
Practice Address - Phone:203-661-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14415208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation