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General NPI Number Information
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NPI Number | 1972967669
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Entity Type | Individual
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Provider Name | ABBY WONG MD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 365 MONTAUK AVENUE DEPARTMENT OF SURGERY
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City | NEW LONDON
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State | CT
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Zip | 06320
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Country | US
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Telephone | 860-443-3147
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Fax |
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Provider Business Mailing Address
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Address Line | 365 MONTAUK AVE DEPARTMENT OF SURGERY
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City | NEW LONDON
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State | CT
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Zip | 06320
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Country | US
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Telephone | 860-443-3147
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Fax |
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 75836
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License Number State | CT
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