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NPI Code Detail

MEDICARE: DR. KHEMIN WONG M.D.

MEDICARE:  DR. KHEMIN  WONG  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician128813NY

General Provider Information

NPI Number : 1134270127
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KHEMIN WONG M.D.
Provider Business Mailing Address
First Line : 18 EAST BROADWAY
Second Line : SUITE# 503
City : NEW YORK
State : NY
Zip : 10002
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18 E BROADWAY
Second Line : SUITE# 503
City : NEW YORK
State : NY
Zip : 10002-6803
Country : US
Telephone Number : 212-226-2251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 07/08/2007

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Directions to “ DR. KHEMIN WONG M.D.” Practice Location

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