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General NPI Number Information
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NPI Number | 1245511385
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Entity Type | Individual
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Provider Name | ALICE WONG O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 966 W STREET RD
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City | WARMINSTER
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State | PA
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Zip | 18974-3124
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Country | US
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Telephone | 215-347-1000
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Fax | 215-773-8205
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Provider Business Mailing Address
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Address Line | 966 W STREET RD
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City | WARMINSTER
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State | PA
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Zip | 18974-3124
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Country | US
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Telephone | 215-347-1000
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Fax | 215-773-8205
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG002528
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License Number State | PA
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