Basic Information
| Provider Information | |||||||||
| NPI: | 1114946233 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONG | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 GUSTAVE L LEVY PLACE | ||||||||
| Address2: | BOX 3000 MOUNT SINAI DEPARTMENT OF MEDICINE | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129873100 | ||||||||
| FaxNumber: | 2127315210 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 EAST 98TH STREET | ||||||||
| Address2: | 10TH FLOOR BO MOUNT SINAI HOSPITAL PULMONARY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122415656 | ||||||||
| FaxNumber: | 2122418866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 230692 | NY | X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 230692 | NY | X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.