Provider Demographics
NPI:1619076833
Name:GONG, YUHONG (MD)
Entity type:Individual
Prefix:
First Name:YUHONG
Middle Name:
Last Name:GONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MAIN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1969
Mailing Address - Country:US
Mailing Address - Phone:978-687-0481
Mailing Address - Fax:978-725-2505
Practice Address - Street 1:92 MONTVALE AVE STE 3675
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3625
Practice Address - Country:US
Practice Address - Phone:781-438-1800
Practice Address - Fax:781-438-1822
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT57107207R00000X, 207RE0101X
MA229275207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine