MEDICARE: MR. YIU LING WONG RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	038957	NY

General Provider Information

NPI Number	:	1639492937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YIU LING WONG RPH

Provider Business Mailing Address
First Line	:	151 E 170TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-7014
Country	:	US
Telephone Number	:	718-293-5832
Fax Number	:	718-293-6349

Provider Business Practice Location Address
First Line	:	151 E 170TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-7014
Country	:	US
Telephone Number	:	718-293-5832
Fax Number	:	718-293-6349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	03/01/2010

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