Active NPI
Sally S Wong, M.S., R.D., C.D.N
- Registered Dietitian
- New York, NY
National Provider Identifier
1033308366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 005757-1
- Practice address
- 254 Canal St
Suite 3002
New York, NY 10013-3501 - Phone
- (212) 431-8808
- NPI assigned
- Oct 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 005757-1 | NY | Primary |
Addresses
Primary practice location
254 Canal St
Suite 3002
New York, NY 10013-3501
Mailing address
15014 Jewel Ave
Apt. 53B
Flushing, NY 11367-1434
Phone (917) 696-4665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005757-1 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1033308366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15014 JEWEL AVE",
"address_2": "APT. 53B",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671434",
"telephone_number": "917-696-4665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 CANAL ST",
"address_2": "SUITE 3002",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100133501",
"telephone_number": "212-431-8808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "SALLY",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "M.S., R.D., C.D.N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-23",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "005757-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.