Provider Demographics
NPI:1710443163
Name:WONG, CHRISTINA GERHARDSTEIN (PHD, ABPP-CN)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:GERHARDSTEIN
Last Name:WONG
Suffix:
Gender:F
Credentials:PHD, ABPP-CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVE STE 3850S
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-345-1313
Mailing Address - Fax:914-345-5004
Practice Address - Street 1:19 BRADHURST AVE STE 3850S
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-345-1313
Practice Address - Fax:914-345-5004
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30621103G00000X
NY026394103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist