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General NPI Number Information
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NPI Number | 1467180364
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Entity Type | Individual
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Provider Name | BOBBIE-ANGELA WONG
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Gender | Female
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 408 PAULDING AVE STE B
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City | NORTHVALE
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State | NJ
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Zip | 07647-1428
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Country | US
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Telephone | 201-719-5919
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Fax |
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Provider Business Mailing Address
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Address Line | 39 LANRAM RD
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City | TAPPAN
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State | NY
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Zip | 10983-1735
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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