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General NPI Number Information
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NPI Number | 1043670912
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Entity Type | Individual
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Provider Name | RACHEL SHELBY WONG ACNP-BC, RN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 622 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-9876
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Fax |
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Provider Business Mailing Address
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Address Line | 2051 8TH AVE APT 4A
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City | NEW YORK
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State | NY
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Zip | 10026-3273
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Country | US
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Telephone | 925-819-0776
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 702873-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 431290
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License Number State | NY
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