Individual
KEVIN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
100 MERRICK RD, ROCKVILLE CENTRE, NY 11570-4800
(516) 321-2589
Mailing address
50 WINTER ST, QUINCY, MA 02169-8726
(178) 188-8229
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
4964
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
06/01/2022
Last updated
06/01/2022
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