MEDICARE: MR. YATMAN WONG FNP-C

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	363LF0000X	Family Nurse Practitioner	F01260267	NY

General Provider Information

NPI Number	:	1831048396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YATMAN WONG FNP-C

Provider Business Mailing Address
First Line	:	11016 72ND AVE APT 503
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11016 72ND AVE APT 503
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4917
Country	:	US
Telephone Number	:	917-246-1029
Fax Number	:

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

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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