Provider Demographics
NPI:1962153171
Name:WONG, CHRISTINA (DNP)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 ROUTE 9W STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6764
Mailing Address - Country:US
Mailing Address - Phone:347-881-6264
Mailing Address - Fax:
Practice Address - Street 1:3125 ROUTE 9W STE 204
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6764
Practice Address - Country:US
Practice Address - Phone:914-502-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF403944-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty