Individual
CARMEN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
104 W 40TH ST STE 416, NEW YORK, NY 10018-3617
(212) 369-6757
Mailing address
104 WEST 4TH STREET, NEW YORK, NY 10014
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404821
NY
Other
Enumeration date
03/07/2023
Last updated
08/28/2023
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