Healthcare Provider Details

I. General information

NPI: 1982682076
Provider Name (Legal Business Name): HONG-THAO THIEU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/23/2024
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WAHINGTON STREET WELLESLEY WOMEN'S CARE SUITE 764
NEWTON MA
02462
US

IV. Provider business mailing address

2000 WAHINGTON STREET WELLESLEY WOMEN'S CARE SUITE 764
NEWTON MA
02462
US

V. Phone/Fax

Practice location:
  • Phone: 617-965-7800
  • Fax: 617-965-4581
Mailing address:
  • Phone: 617-965-7800
  • Fax: 617-965-4581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number223948
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: