Healthcare Provider Details

I. General information

NPI: 1154059996
Provider Name (Legal Business Name): ZHI YING BERNADETTE WONG MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEMORIAL SLOAN KETTERING CANCER CENTER 1275 YORK AVENUE
NEW YORK NY
10065
US

IV. Provider business mailing address

425 E 76TH ST APT 9C
NEW YORK NY
10021-2516
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License NumberP113683
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: