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General NPI Number Information
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NPI Number | 1760802680
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Entity Type | Individual
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Provider Name | LINDA MARIE WONG
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Gender | Female
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 128 WENDEL AVE
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City | TONAWANDA
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State | NY
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Zip | 14223-2919
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Country | US
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Telephone | 718-938-6182
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Fax |
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Provider Business Mailing Address
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Address Line | 12803 WEST AVE APT 6104
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City | SAN ANTONIO
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State | TX
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Zip | 78216-1820
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Country | US
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Telephone | 718-938-6182
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | T3903
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License Number State | TX
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