Provider Demographics
NPI:1477143196
Name:YAMAMOTO-WONG, YUKO
Entity Type:Individual
Prefix:
First Name:YUKO
Middle Name:
Last Name:YAMAMOTO-WONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 EAST 41ST ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6927
Mailing Address - Country:US
Mailing Address - Phone:212-273-6272
Mailing Address - Fax:212-273-6427
Practice Address - Street 1:227 EAST 41ST ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6927
Practice Address - Country:US
Practice Address - Phone:212-273-6272
Practice Address - Fax:212-273-6427
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024698124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist