Provider Demographics
NPI:1427699057
Name:WONG, OI LEE TIFFANY (MSN)
Entity type:Individual
Prefix:
First Name:OI LEE
Middle Name:TIFFANY
Last Name:WONG
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E 72ND ST OFC 500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0600
Mailing Address - Country:US
Mailing Address - Phone:212-746-2441
Mailing Address - Fax:646-962-0236
Practice Address - Street 1:428 E 72ND ST OFC 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0600
Practice Address - Country:US
Practice Address - Phone:212-746-2441
Practice Address - Fax:646-962-0236
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-312189-01363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology