Provider Demographics
NPI:1902692957
Name:WONG, THOMAS VINCENT (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:VINCENT
Last Name:WONG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1468 MADISON AVE
Mailing Address - Street 2:ANNENBERG BLDG. 15TH FLOOR, ROOM 50
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-4398
Mailing Address - Fax:646-537-9681
Practice Address - Street 1:1468 MADISON AVE
Practice Address - Street 2:ANNENBERG BLDG. 15TH FLOOR, ROOM 50
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-4398
Practice Address - Fax:646-537-9681
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program