Lilliam R Wong-Ryan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA05577900 Issued in NJ

Practice address

3 University Plaza
Suite 117
Hackensack, NJ 07601

Phone

(201) 487-9104

Fax

(585) 206-4958

NPI assigned

Jun 24, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Lilliam R Wong Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1983

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1669041570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLAZA",
            "address_2": "SUITE 117",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-487-9104",
            "fax_number": "585-206-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLAZA",
            "address_2": "SUITE 117",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-487-9104",
            "fax_number": "585-206-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG-RYAN",
        "first_name": "LILLIAM",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2023-09-27",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "176641",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "176641",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA05577900",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA05577900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "liryanmd@icloud.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 W 30th St Apt 26D",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100011378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lilliam.wong@nyspi.columbia.edu",
            "affiliation": "Y",
            "endpointDescription": "direct secure email",
            "affiliationName": "New York State Psychiatric Institute",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4941 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100342303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LILLIAM",
            "last_name": "WONG",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracy Wissell, RN-BC, NP-C
• Berengere Sybille Woel, M.D.
• Joshua Lewis Wohl
• Robin B Wolf, MS, CGC
• Krysten Wondrack, NP
• Austin H Wong, M.D.
• Jonathan Wayne Wong
• Sarah Wong, M.D.
• Tracie Wong, MD
• Philip G Woodham

• Psychiatry Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.