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General NPI Number Information
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NPI Number | 1821674557
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Entity Type | Individual
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Provider Name | LEWIS ALEXANDER WONG MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 13172 40TH RD
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City | FLUSHING
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State | NY
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Zip | 11354-5137
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Country | US
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Telephone | 718-587-1111
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Fax | 718-886-3903
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Provider Business Mailing Address
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Address Line | 125 WALKER ST
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City | NEW YORK
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State | NY
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Zip | 10013-4135
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Country | US
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Telephone | 212-226-8866
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Fax | 212-226-2289
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 321887
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License Number State | NY
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