National Provider Identifier
Justin Wong, PT, DPT
Justin Wong, PT, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Grand Island, NY and a listed phone number of (716) 773-4323.
Profile Overview
- NPI
- 1417540006
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- February 16, 2021
- Last Updated
- December 30, 2021
Practice Location
- 1801 Grand Island Blvd
- Grand Island, NY 14072-2249
Phone: (716) 773-4323
Mailing Address
- 1801 Grand Island Blvd Ste 100
- Grand Island, NY 14072-2249
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1417540006
- Entity Type
- Individual
- Last Name
- Wong
- First Name
- Justin
- Name Prefix
- Dr.
- Credential
- PT, DPT
- Mailing Street Address
- 1801 Grand Island Blvd Ste 100
- Mailing City
- Grand Island
- Mailing State
- NY
- Mailing ZIP Code
- 14072-2249
- Mailing Country
- US
- Practice Street Address
- 1801 Grand Island Blvd
- Practice City
- Grand Island
- Practice State
- NY
- Practice ZIP Code
- 14072-2249
- Practice Country
- US
- Practice Phone
- (716) 773-4323
- Practice Fax
- (716) 773-9418
- Enumeration Date
- February 16, 2021
- Last Updated
- December 30, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 30, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)