Individual
DR. MAICIE M WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16 E 79TH ST, SUITE 23, NEW YORK, NY 10075-0150
(212) 355-8100
Mailing address
16 E 79TH ST, SUITE 23, NEW YORK, NY 10075-0150
(212) 355-8100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2142691
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02183599
—
NY
Enumeration date
11/16/2006
Last updated
04/05/2016
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