Basic Information
| Provider Information | |||||||||
| NPI: | 1255598033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WONG | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | GIAJING | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | STONY BROOK UNIVERSITY HOSPITAL | ||||||||
| Address2: | HEALTH SCIENCES CENTER, T16-020 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117947048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314441106 | ||||||||
| FaxNumber: | 6314442493 | ||||||||
| Practice Location | |||||||||
| Address1: | STONY BROOK UNIVERSITY HOSPITAL | ||||||||
| Address2: | HEALTH SCIENCES CENTER, T16-020 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117947048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314441106 | ||||||||
| FaxNumber: | 6314442493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2008 | ||||||||
| LastUpdateDate: | 07/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 261392 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.