Provider Demographics
NPI:1841672961
Name:WONG, CHAK SHUI
Entity type:Individual
Prefix:
First Name:CHAK SHUI
Middle Name:
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 1:4265 KISSENA BLVD
Mailing Address - Street 2:SUITE LL4
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3273
Mailing Address - Country:US
Mailing Address - Phone:718-353-2300
Mailing Address - Fax:718-353-2454
Practice Address - Street 1:4265 KISSENA BLVD
Practice Address - Street 2:SUITE LL4
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3273
Practice Address - Country:US
Practice Address - Phone:718-353-2300
Practice Address - Fax:718-353-2454
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294462208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics