Active NPI
Michael Jun Wong, DPT
- Physical Therapist
- Long Island City, NY
National Provider Identifier
1609140730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 029700-1
- Practice address
- 2430 Skillman Ave
Long Island City, NY 11101-4524 - Phone
- (718) 729-5083
- NPI assigned
- Mar 7, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 029700-1 | NY | Primary |
Addresses
Primary practice location
2430 Skillman Ave
Long Island City, NY 11101-4524
Mailing address
15756 24TH Rd
Whitestone, NY 11357-3917
Phone (646) 338-9664
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 |
|---|---|---|---|
| 029700-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1609140730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15756 24TH RD",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113573917",
"telephone_number": "646-338-9664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 SKILLMAN AVE",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111014524",
"telephone_number": "718-729-5083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "MICHAEL",
"middle_name": "JUN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-07",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "029700-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.