Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1922038389 |
---|---|
Provider Name | Mrs. Angela Lynn Quan-Wong |
First Address | Bayside, NY 11361-3129 |
Second Address | Bronx, NY 10468-3904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |