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Individual
DR. IRENE WONG
Active
Individual
DR. IRENE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10295000
NJ
207Q00000X
Family Medicine Physician
260111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03480408
—
NY
Enumeration date
03/01/2012
Last updated
06/04/2018
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