Basic Information
| Provider Information | |||||||||
| NPI: | 1528032257 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WONG | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 ALBANY POST RD | ||||||||
| Address2: | VA HUDSON VALLEY HEALTH CARE SYSTEM - OPTOMETRY SERVICE | ||||||||
| City: | MONTROSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105481415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147374400 | ||||||||
| FaxNumber: | 9147884373 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 ALBANY POST RD | ||||||||
| Address2: | VA HUDSON VALLEY HEALTH CARE SYSTEM - OPTOMETRY SERVICE | ||||||||
| City: | MONTROSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105481415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147374400 | ||||||||
| FaxNumber: | 9147884373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | VUT 005839 | NY | Y | Eye and Vision Services Providers | Optometrist | 152W00000X | OD0000002339 | TN | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 4024 | MA | N | Eye and Vision Services Providers | Optometrist |
No ID Information.