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General NPI Number Information
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NPI Number | 1508104399
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Entity Type | Individual
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Provider Name | SINKONG WONG O.T
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Gender | Male
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 03/06/2016
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Provider Practice Location Address
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Address Line | 13665 37TH AVE CENTER LIGHT PACE CENTER
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City | FLUSHING
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State | NY
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Zip | 11354-4110
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Country | US
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Telephone | 917-975-8792
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 527546
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City | FLUSHING
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State | NY
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Zip | 11352-7546
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Country | US
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Telephone | 917-975-8792
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 017545-1
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License Number State | NY
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