Individual
MR. FREDRICK VA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355
(347) 804-5653
Mailing address
5645 MAIN ST, FLUSHING, NY 11355-5045
(347) 804-5653
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
021066
NY
Other
Enumeration date
07/28/2017
Last updated
03/04/2019
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