Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 074493 | NY |
NPI | 1003286766 |
---|---|
Provider Name | Ms. Debi Wong |
First Address | New Hyde Park, NY 11042-2006 |
Second Address | New Hyde Park, NY 11042-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2015 |
Last Update Date | 06/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
074493 | THE UNIVERSITY OF THE STATE OF NEW YORK (01) | NY |
YK306649DS | DEPARTMENT OF HEALTH (01) | NY |