Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 289253 | NY |
NPI | 1033523717 |
---|---|
Provider Name | Dr. Bonnie Wong |
First Address | Brooklyn, NY 11203-2097 |
Second Address | Brooklyn, NY 11203-2097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2014 |
Last Update Date | 23/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033523717 | NPI (01) |