Provider Demographics
NPI:1790975373
Name:WONG, KWOK S (MA, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:KWOK
Middle Name:S
Last Name:WONG
Suffix:
Gender:M
Credentials:MA, OTR/L
Other - Prefix:MR
Other - First Name:ALBERT
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, OTR/L
Mailing Address - Street 1:4 DOROTHY CIR
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1898
Mailing Address - Country:US
Mailing Address - Phone:610-792-3681
Mailing Address - Fax:
Practice Address - Street 1:4 DOROTHY CIR
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1898
Practice Address - Country:US
Practice Address - Phone:610-792-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008966225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist