Active NPI
Tak Wong
- Pharmacist
- Rockville, MD
National Provider Identifier
1396348496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11920
- Practice address
- 16837 Crabbs Branch Way
Rockville, MD 20855-2215 - Phone
- (301) 840-1777
- Fax
- (844) 411-6258
- NPI assigned
- Nov 19, 2020
- Last updated
- Nov 19, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11920 | MD | Primary |
Addresses
Primary practice location
16837 Crabbs Branch Way
Rockville, MD 20855-2215
Mailing address
14241 Kings Crossing Blvd Unit 100
Boyds, MD 20841-4343
Phone (240) 899-5152
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11920 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past | Accepting new patients | |
| Giant of Maryland LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1396348496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14241 KINGS CROSSING BLVD UNIT 100",
"city": "BOYDS",
"state": "MD",
"postal_code": "208414343",
"telephone_number": "240-899-5152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16837 CRABBS BRANCH WAY",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208552215",
"telephone_number": "301-840-1777",
"fax_number": "844-411-6258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "TAK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "11920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.