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General NPI Number Information
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NPI Number | 1497712657
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Entity Type | Individual
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Provider Name | GREGORY WONG DEMEO D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 4745 OGLETOWN STANTON RD SUITE 106
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City | NEWARK
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State | DE
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Zip | 19713-2067
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Country | US
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Telephone | 302-454-9800
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Fax | 302-454-6446
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Provider Business Mailing Address
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Address Line | 4735 OGLETOWN STANTON RD SUITE 1109
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City | NEWARK
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State | DE
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Zip | 19713-2072
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Country | US
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Telephone | 302-454-9800
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Fax | 302-454-6446
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C20003423
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License Number State | DE
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