Individual
MRS. MARIA LIZA GACKO WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
317 NORTH ST, WHITE PLAINS, NY 10605-2209
(914) 597-4080
Mailing address
14 NOSBAND AVE, APT 1H, WHITE PLAINS, NY 10605-2073
(917) 348-0635
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
019733-1
NY
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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