Provider Demographics
NPI:1255372926
Name:WONG, YIU MING
Entity type:Individual
Prefix:
First Name:YIU
Middle Name:MING
Last Name:WONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4108
Mailing Address - Country:US
Mailing Address - Phone:212-219-8668
Mailing Address - Fax:212-219-8679
Practice Address - Street 1:123 WALKER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4108
Practice Address - Country:US
Practice Address - Phone:212-219-8668
Practice Address - Fax:212-219-8679
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35007183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist