Provider Demographics
NPI:1154682946
Name:WONG, SAI KHEE
Entity Type:Individual
Prefix:
First Name:SAI
Middle Name:KHEE
Last Name:WONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 EAST SHORE RD.
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-2132
Mailing Address - Country:US
Mailing Address - Phone:718-961-3211
Mailing Address - Fax:
Practice Address - Street 1:355 EAST SHORE RD.
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-2132
Practice Address - Country:US
Practice Address - Phone:718-961-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128426208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice