Provider Demographics
NPI:1700084027
Name:KONG, HONGXIA (LAC)
Entity Type:Individual
Prefix:
First Name:HONGXIA
Middle Name:
Last Name:KONG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:HONGXIA
Other - Middle Name:
Other - Last Name:KONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1 W 34TH ST RM 903
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3011
Mailing Address - Country:US
Mailing Address - Phone:212-564-3324
Mailing Address - Fax:212-564-3732
Practice Address - Street 1:1 W 34TH ST RM 903
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3011
Practice Address - Country:US
Practice Address - Phone:212-564-3324
Practice Address - Fax:212-564-3732
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003330171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist