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General NPI Number Information
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NPI Number | 1114185865
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Entity Type | Individual
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Provider Name | MS. MARCIA WONG
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Gender | Female
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 4209 28TH ST
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-4130
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Country | US
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Telephone | 347-758-2789
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Fax |
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Provider Business Mailing Address
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Address Line | 345 RIVERSIDE DR APT 5H
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City | NEW YORK
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State | NY
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Zip | 10025-3430
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Country | US
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Telephone |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 256523
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License Number State | NY
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