Organization
TOTAL HEALTH AT LICH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN WONG MD (GROUP MANAGER)
(718) 780-2777
Entity
Organization
Contact information
Practice address
350 HENRY ST, BROOKLYN, NY 11201-6001
(516) 569-0696
(516) 569-3677
Mailing address
350 HENRY ST, BROOKLYN, NY 11201-6001
(516) 569-0696
(516) 569-3677
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
05/24/2006
Last updated
10/02/2007
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