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General NPI Number Information
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NPI Number | 1235192576
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Entity Type | Individual
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Provider Name | KWOK KIN WONG MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 450 BROOKLINE AVE MAYER BUILDING 413
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City | BOSTON
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State | MA
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Zip | 02215-5418
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Country | US
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Telephone | 617-632-6084
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Fax | 617-582-7839
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Provider Business Mailing Address
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Address Line | 450 BROOKLINE AVE MAYER BUILDING 413
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City | BOSTON
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State | MA
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Zip | 02215-5418
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Country | US
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Telephone | 617-632-6084
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Fax | 617-582-7839
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 157104
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License Number State | MA
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