Individual
KEVIN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 COMMUNITY DR, ANESTHESIA DEPT., MANHASSET, NY 11030-3816
(516) 562-0100
Mailing address
68 S SERVICE RD, SUITE 350, MELVILLE, NY 11747-2354
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
579907
NY
Other
Enumeration date
12/16/2014
Last updated
02/25/2015
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