Provider Demographics
NPI:1477823359
Name:WONG, REGINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REGINE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 5TH AVE STE 1012
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4512
Mailing Address - Country:US
Mailing Address - Phone:646-893-8386
Mailing Address - Fax:
Practice Address - Street 1:286 5TH AVE STE 1012
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4512
Practice Address - Country:US
Practice Address - Phone:646-893-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist