Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 006917 | NY |
NPI | 1043605132 |
---|---|
Provider Name | Dr. Andrew K Wong |
First Address | Bronx, NY 10461-6268 |
Second Address | Bronx, NY 10461-6268 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 15/03/2021 |