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Organization

JIMMY WONG M.D., P.L.L.C.

Active
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Organization

JIMMY WONG M.D., P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JIMMY WONG M.D. (PHYSICIAN)
(917) 660-6227
Entity
Organization

Contact information

Practice address
33 BOWERY, SUITE B201, NEW YORK, NY 10002-6745
(212) 431-3111
Mailing address
33 BOWERY, SUITE B201, NEW YORK, NY 10002-6745
(212) 431-3111

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
249942
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03104441
—
NY
01
—
1114162898
NPI
NY
01
—
A300000825
MEDICARE PTAN
NY
Enumeration date
09/20/2009
Last updated
09/20/2009
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