Basic Information
Provider Information
NPI: 1922205632
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HONG
FirstName: RICHARD
MiddleName: EUGENE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19 BRADHURST AVE STE 3100N
Address2:  
City: HAWTHORNE
State: NY
PostalCode: 105322140
CountryCode: US
TelephoneNumber: 9149099018
FaxNumber: 9149099028
Practice Location
Address1: 100 WOODS RD
Address2:  
City: VALHALLA
State: NY
PostalCode: 105951530
CountryCode: US
TelephoneNumber: 9144937000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/27/2007
LastUpdateDate: 02/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085P0229X258834-1NYN Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
2085R0202X258834-1NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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