MEDICARE: MS. PUI YIU CORINA WONG PA

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	363A00000X	Physician Assistant	P74127	NY

General Provider Information

NPI Number	:	1518299965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PUI YIU CORINA WONG PA

Provider Business Mailing Address
First Line	:	1 BOND ST
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2408
Country	:	US
Telephone Number	:	516-858-9276
Fax Number	:	516-441-5882

Provider Business Practice Location Address
First Line	:	1 BOND ST
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2408
Country	:	US
Telephone Number	:	516-858-9276
Fax Number	:	516-441-5882

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

Provider Enumeration Date	:	02/10/2010
Last Update Date	:	02/25/2026

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