Doctor Name: | DR. KENNETH RICHARD WONG |
NPI Number: | 1669826285 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 910442318 |
Business Practice Address: | 525 East 68th Street, Mailbox 301 Ny Presbyterian Cornell- Emergency Medicine Residency New York City, NY - 10021 |
Business Phone Number: | 9499030215 |
Business Fax Number: | |
Mailing Address: | 525 East 68th Street, Mailbox 301, Ny Presbyterian Cornell- Emergency Medicine Residency NEW YORK CITY |
State: | NY |
Postal Code: | 10021 |
Phone Number: | 9499030215 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2016 |
NPI Last Update Date: | 05/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 910442318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |