Individual
DR. SAMUEL WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13626 37TH AVE, FLUSHING, NY 11354-6533
(718) 886-1200
Mailing address
PO BOX 426, OLD WESTBURY, NY 11568-0426
(516) 567-6885
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
208297
NY
207VE0102X
Reproductive Endocrinology Physician
208297
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02021850
—
NY
Enumeration date
04/08/2006
Last updated
02/21/2013
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