Healthcare Provider Details

I. General information

NPI: 1881261220
Provider Name (Legal Business Name): AMELIA WING-HAANG WONG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270-05 76TH AVENUE RESEARCH BLDG - C LEVEL ROOM 039AB
NEW HYDE PARK NY
11040
US

IV. Provider business mailing address

270-05 76TH AVENUE RESEARCH BLDG - C LEVEL ROOM 039AB
NEW HYDE PARK NY
11040
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-4863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDOSR-527
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number343726-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: