Provider Demographics
NPI:1063848562
Name:WONG, SHUK-LING (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHUK-LING
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EATON RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6510
Mailing Address - Country:US
Mailing Address - Phone:516-220-3689
Mailing Address - Fax:516-390-3520
Practice Address - Street 1:15 EATON RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-6510
Practice Address - Country:US
Practice Address - Phone:516-220-3689
Practice Address - Fax:516-390-3520
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035627-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist