Provider Demographics
NPI:1720674906
Name:WONG, ALICE NGAR SIN I (AGPCNP)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:NGAR SIN
Last Name:WONG
Suffix:I
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PLAZA ST E APT 7A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5074
Mailing Address - Country:US
Mailing Address - Phone:917-885-2728
Mailing Address - Fax:
Practice Address - Street 1:50 PLAZA ST E APT 7A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5074
Practice Address - Country:US
Practice Address - Phone:917-885-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310092363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health