Provider Demographics
NPI:1821095233
Name:WONG, CHING
Entity Type:Individual
Prefix:
First Name:CHING
Middle Name:
Last Name: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 1:6724 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5418
Mailing Address - Country:US
Mailing Address - Phone:718-478-6800
Mailing Address - Fax:718-748-2439
Practice Address - Street 1:6724 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5418
Practice Address - Country:US
Practice Address - Phone:718-478-6800
Practice Address - Fax:718-748-2439
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139344207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB87394Medicare UPIN