Provider Demographics
NPI:1831462290
Name:WONG, RAINBOW YUK YING (RD)
Entity Type:Individual
Prefix:MS
First Name:RAINBOW
Middle Name:YUK YING
Last Name:WONG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15218 UNION TPKE APT 4M
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3923
Mailing Address - Country:US
Mailing Address - Phone:917-279-0028
Mailing Address - Fax:
Practice Address - Street 1:9945 67TH RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3056
Practice Address - Country:US
Practice Address - Phone:347-880-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005396133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal