Individual
MS. SALLY S WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D., C.D.N
Contact information
Practice address
254 CANAL ST, SUITE 3002, NEW YORK, NY 10013-3501
(212) 431-8808
Mailing address
15014 JEWEL AVE, APT. 53B, FLUSHING, NY 11367-1434
(917) 696-4665
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005757-1
NY
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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