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General NPI Number Information
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NPI Number | 1194705012
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Entity Type | Individual
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Provider Name | CHRISTOPHER J WONG D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 559 W GERMANTOWN PIKE
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City | EAST NORRITON
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State | PA
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Zip | 19403-4250
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Country | US
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Telephone | 484-622-1244
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Fax | 484-622-1542
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Provider Business Mailing Address
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Address Line | PO BOX 820137
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City | PHILADELPHIA
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State | PA
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Zip | 19182-0137
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Country | US
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Telephone | 610-270-2352
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Fax | 610-270-2358
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | OS012448
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | OS012448
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License Number State | PA
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