Provider Demographics
NPI:1073773040
Name:WONG, MEREDITH J (MD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:J
Last Name:WONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5 W 86TH ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3663
Mailing Address - Country:US
Mailing Address - Phone:646-715-4642
Mailing Address - Fax:646-607-9495
Practice Address - Street 1:5 W 86TH ST APT 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3663
Practice Address - Country:US
Practice Address - Phone:646-715-4642
Practice Address - Fax:646-607-9495
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2495892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry