Healthcare Provider Details

I. General information

NPI: 1376862698
Provider Name (Legal Business Name): SZE SCOTT K WONG RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 N. WATER ST
GREENWICH CT
06830
US

IV. Provider business mailing address

13 N WATER ST
GREENWICH CT
06830-5814
US

V. Phone/Fax

Practice location:
  • Phone: 203-531-3323
  • Fax: 203-531-3325
Mailing address:
  • Phone: 203-531-3323
  • Fax: 203-531-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT 0009381
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: