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General NPI Number Information
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NPI Number | 1679854152
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Entity Type | Individual
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Provider Name | JENNY CHUN-YIN CHIM-WONG L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 08/29/2011
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Last Update Date | 08/29/2011
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Provider Practice Location Address
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Address Line | 6501 BAY PKWY C LEVEL,
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City | BROOKLYN
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State | NY
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Zip | 11204-3948
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Country | US
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Telephone | 917-238-4415
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Fax | 718-259-0442
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Provider Business Mailing Address
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Address Line | 7521 16TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-1005
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Country | US
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Telephone | 917-238-4415
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Fax | 718-259-0442
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 069402-1
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License Number State | NY
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