Provider Demographics
NPI:1912152984
Name:DONG-HONG SHONG, M.D., P.C.
Entity Type:Organization
Organization Name:DONG-HONG SHONG, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG-HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-539-3648
Mailing Address - Street 1:13668 ROOSEVELT AVE STE 4B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5510
Mailing Address - Country:US
Mailing Address - Phone:718-539-3648
Mailing Address - Fax:718-661-3758
Practice Address - Street 1:13668 ROOSEVELT AVE STE 4B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5510
Practice Address - Country:US
Practice Address - Phone:718-539-3648
Practice Address - Fax:718-661-3758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01722018Medicaid
NY02574Medicare PIN
NY01722018Medicaid