MEDICARE: YU SHU WONG

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
1	171100000X	Acupuncturist	002484	NY

General Provider Information

NPI Number	:	1225886740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YU SHU WONG

Provider Business Mailing Address
First Line	:	4186 GLENWOOD ST
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11363-1719
Country	:	US
Telephone Number	:	516-765-6689
Fax Number	:	516-883-8323

Provider Business Practice Location Address
First Line	:	626 PORT WASHINGTON BLVD
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3714
Country	:	US
Telephone Number	:	516-883-8288
Fax Number	:	516-883-8323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2024
Last Update Date	:	05/09/2024

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Directions to “ YU SHU WONG ” Practice Location

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