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NPI Code Detail

MEDICARE: SOPHIA WONG

MEDICARE: SOPHIA WONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist

General Provider Information

NPI Number : 1629740055
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA WONG
Provider Business Mailing Address
First Line : 181 SAINT MARY ST
Second Line :
City : NEEDHAM HEIGHTS
State : MA
Zip : 02494-3128
Country : US
Telephone Number : 617-981-2406
Fax Number :
Provider Business Practice Location Address
First Line : 181 SAINT MARY ST
Second Line :
City : NEEDHAM HEIGHTS
State : MA
Zip : 02494-3128
Country : US
Telephone Number : 617-981-2406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2021
Last Update Date : 10/04/2021

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Directions to “ SOPHIA WONG ” Practice Location

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