Individual
MICHELLE ELIZABETH WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
1722 TROUTMAN ST FL 1, RIDGEWOOD, NY 11385-1015
(646) 630-1328
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310032
NY
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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