Regina Fong NP in Psychiatry, P.C.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

REGINA FONG NP IN PSYCHIATRY, P.C.

Practice address

88 Terry Rd
Smithtown, NY 11787-3811

Phone

(631) 406-4056

NPI assigned

Oct 21, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Regina Fong, PMHNPNPI 1285017236

Title

Owner

Phone

(631) 406-4056

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Regina K Fong, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Hyde Park, NY
  • NPI 1285017236

  NY, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1265195697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "631-406-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGINA FONG NP IN PSYCHIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-406-4056",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Smithtown, NY
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.