Fong, Jay G.
Fong, Jay G. is an individual health care provider with primary practice located at 55 Lake Ave North , Worcester MA 01655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Fong, Jay G. can be contacted via phone (774) 441-8082.Contact Information
Primary practice address
55 Lake Ave North
Worcester MA 01655
Phone: (774) 441-8082
Fax: (774) 441-8056
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | 230289 | Massachusetts |
Profile Details
NPI number | 1801977640 |
---|---|
LBN Legal business name | Fong, Jay G. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 18th, 2006 |
Last updated | Nov 9th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1801977640 | NPPES |
Massachusetts | MEDICAID | 110075071A |
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