| Doctor Name: | MR. JERRY KONG |
| NPI Number: | 1023293909 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 25MP00133300 |
| Business Practice Address: | 501 Iron Bridge Rd Suite 1 Freehold, NJ - 077285304 |
| Business Phone Number: | 7327202565 |
| Business Fax Number: | 7327202556 |
| Mailing Address: | 501 Iron Bridge Rd, Suite 1 FREEHOLD |
| State: | NJ |
| Postal Code: | 077285304 |
| Phone Number: | 7327202565 |
| Fax Number: | 7327202556 |
| NPI Enumeration Date: | 01/09/2008 |
| NPI Last Update Date: | 01/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 25MP00133300 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |