Provider Demographics
NPI:1720376056
Name:WONG, KATHERINE YAU (OD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:YAU
Last Name:WONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MADISON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0069
Mailing Address - Country:US
Mailing Address - Phone:212-213-3737
Mailing Address - Fax:212-213-3787
Practice Address - Street 1:185 MADISON AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0069
Practice Address - Country:US
Practice Address - Phone:212-213-3737
Practice Address - Fax:212-213-3787
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist