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Individual

ANITA MARIE WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
23 HAMILTON PL, LAKE GROVE, NY 11755-1916
(631) 935-2729
Mailing address
23 HAMILTON PL, LAKE GROVE, NY 11755-1916
(631) 935-2729

Taxonomy

Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
0003278
NY

Other

Enumeration date
12/17/2020
Last updated
12/17/2020
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