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Individual

LESLIE P WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
370 E RIDGE RD STE 20, ROCHESTER, NY 14621-1239
(585) 922-0400
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
12745135-1205
UT
207RN0300X
Nephrology Physician
Primary
328842
NY
207RN0300X
Nephrology Physician
C54492
CA
207RN0300X
Nephrology Physician
MD00043067
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
186164
L I
WA
05
8392490
WA
Enumeration date
09/30/2005
Last updated
07/22/2024
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