Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 007691 | NY |
N | 225X00000X | Occupational Therapist | 007691-1 | NY |
Y | 225XH1200X | Occupational Therapist - Hand | 007691-1 | NY |
NPI | 1164582219 |
---|---|
Provider Name | Mrs. Josephine Si Nun Wong |
First Address | New York, NY 10013-4552 |
Second Address | New York, NY 10013-4552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 02/05/2014 |