Provider Demographics
NPI:1013376383
Name:WONG, CHI FAI (DPT)
Entity Type:Individual
Prefix:MR
First Name:CHI FAI
Middle Name:
Last Name:WONG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 LAFAYETTE AVENUE
Mailing Address - Street 2:APARTMENT 4J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1341
Mailing Address - Country:US
Mailing Address - Phone:646-752-1705
Mailing Address - Fax:
Practice Address - Street 1:333 LAFAYETTE AVE
Practice Address - Street 2:APARTMENT 4J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1350
Practice Address - Country:US
Practice Address - Phone:646-752-1705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist