Candice Wong, PA-C
Physician Assistant in Mineola, NY. Individual provider (NPI-1).
NPI number1689409153
StatusActive
Last updated in NPPESNov 30, 2024
Details
- NPI
- 1689409153
- Entity type
- Individual (NPI-1)
- Name
- Candice Wong
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 4, 2024
- Certification date
- Nov 30, 2024
- Last updated
- Nov 30, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
259 1st StMineola, NY 11501-3957
Phone 516-663-0333
Mailing address
550 1st AveNew York, NY 10016-6402
Phone 646-929-7870
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