Healthcare Provider Details

I. General information

NPI: 1699161810
Provider Name (Legal Business Name): JOY WONG N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E 70TH ST FL 4
NEW YORK NY
10021-9800
US

IV. Provider business mailing address

7112 17TH AVE
BROOKLYN NY
11204-5155
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2158
  • Fax:
Mailing address:
  • Phone: 646-920-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF3068141
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberF3409411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: