Individual
ROSALIE L. WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5225 NESCONSET HWY, SUITE 36, PORT JEFFERSON STATION, NY 11776
(631) 928-4870
(631) 928-4910
Mailing address
5225 NESCONSET HWY, SUITE 36, PORT JEFFERSON STATION, NY 11776-2053
(631) 928-4870
(631) 928-4910
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
111647
NY
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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