Provider Demographics
NPI:1639456635
Name:KWOK, WAI KEUNG (PT)
Entity type:Individual
Prefix:MR
First Name:WAI KEUNG
Middle Name:
Last Name:KWOK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 BAY PARKWAY
Mailing Address - Street 2:C LEVEL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3948
Mailing Address - Country:US
Mailing Address - Phone:718-238-9392
Mailing Address - Fax:718-238-9379
Practice Address - Street 1:6501 BAY PARKWAY, C LEVEL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3948
Practice Address - Country:US
Practice Address - Phone:718-238-9392
Practice Address - Fax:718-238-9379
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist