Gong, Gary Xin

Gong, Gary Xin is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gong, Gary Xin can be contacted via phone (860) 679-2784.

Contact Information

Primary practice address
263 Farmington Ave Farmington CT 06030-0001
Phone: (860) 679-2784
Fax: (860) 679-3145
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X D61497 Maryland
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 056776 Connecticut

Profile Details

NPI number 1154373157
LBN Legal business name Gong, Gary Xin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Aug 30th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154373157 NPPES
Maryland MEDICAID 4048407000

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