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General NPI Number Information
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NPI Number | 1508431511
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Entity Type | Organization
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Legal Business Name | ELITA WONG, PSYCHIATRIC NURSE PRACTITIONER PLLC
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 223 BEDFORD AVE NO. 888
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City | BROOKLYN
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State | NY
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Zip | 11211
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Country | US
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Telephone | 206-531-7844
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Fax | 503-386-3252
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Provider Business Mailing Address
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Address Line | 223 BEDFORD AVE NO. 888
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City | BROOKLYN
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State | NY
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Zip | 11211
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Country | US
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Telephone | 206-531-7844
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Fax | 503-386-3252
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Authorized Official
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Title or Position | OWNER, PSYCHIATRIC NP
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Name | ELITA WONG
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Credential | PMHNP-BC
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Telephone | 206-531-7844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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