| Doctor Name: | MR. RAYMOND WONG-PAN |
| NPI Number: | 1639197817 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T |
| License Number: | 0171881 |
| Business Practice Address: | 2 W Center St Suite 40 New Paltz, NY - 125612001 |
| Business Phone Number: | 8456413031 |
| Business Fax Number: | |
| Mailing Address: | Po Box 188, GARDINER |
| State: | NY |
| Postal Code: | 125250188 |
| Phone Number: | 8456413031 |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 10/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 0171881 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |