Provider Demographics
NPI:1669760278
Name:WONG, JOYCE S (NP)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:S
Last Name:WONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1209
Mailing Address - Country:US
Mailing Address - Phone:631-878-1543
Mailing Address - Fax:631-874-2559
Practice Address - Street 1:41 BAY AVE
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940-1209
Practice Address - Country:US
Practice Address - Phone:631-878-1543
Practice Address - Fax:631-874-2559
Is Sole Proprietor?:No
Enumeration Date:2011-07-16
Last Update Date:2011-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF305752-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health