Healthcare Provider Details

I. General information

NPI: 1982924882
Provider Name (Legal Business Name): WING-SZE WONG PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 LEAVITT ST 2ND FL.
FLUSHING NY
11354-3440
US

IV. Provider business mailing address

3315 LEAVITT ST 2ND FL.
FLUSHING NY
11354-3440
US

V. Phone/Fax

Practice location:
  • Phone: 917-854-8948
  • Fax:
Mailing address:
  • Phone: 917-854-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050499
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: