Active NPI
Mimi Wai Yee Wong, MA, CCC/SLP-TSSLD
- Speech-Language Pathologist
- Bayside, NY
National Provider Identifier
1992950992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015556-1
- Practice address
- 20832 Cross Island Pkwy
Bayside, NY 11360-1187 - Phone
- (718) 224-3352
- NPI assigned
- Nov 18, 2008
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 015556-1 | NY | Primary |
Addresses
Primary practice location
20832 Cross Island Pkwy
Bayside, NY 11360-1187
Mailing address
5630 206TH St
Oakland Gardens, NY 11364-1725
Phone (917) 620-8487
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015556-1 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226966400000",
"number": "1992950992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5630 206TH ST",
"city": "OAKLAND GARDENS",
"state": "NY",
"postal_code": "113641725",
"telephone_number": "917-620-8487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20832 CROSS ISLAND PKWY",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113601187",
"telephone_number": "718-224-3352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "MIMI",
"middle_name": "WAI YEE",
"name_prefix": "Ms.",
"credential": "MA, CCC/SLP-TSSLD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-18",
"last_updated": "2008-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "015556-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.