Wong, Johnson Tai
Wong, Johnson Tai is an individual health care provider with primary practice located at 8 Hawthorne Pl Suite 104, Boston MA 02114-2335. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wong, Johnson Tai can be contacted via phone (617) 742-5730.Contact Information
Primary practice address
8 Hawthorne Pl Suite 104
Boston MA 02114-2335
Phone: (617) 742-5730
Fax: (617) 742-6917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 53165 | Massachusetts |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 53165 | Massachusetts |
Profile Details
| NPI number | 1659362820 |
|---|---|
| LBN Legal business name | Wong, Johnson Tai |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Sep 11th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659362820 | NPPES |
| Massachusetts | Other | J05499 | BCBS MA |
| Massachusetts | MEDICAID | 3009017 | BCBS MA |
| Massachusetts | Other | 713318 | BCBS MA |
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