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 / Allergy & Immunology 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:
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Health care specialties

SpecialtyCodeLicense #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 Jul 8th, 2007 - about 19 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659362820 NPPES
Massachusetts Other J05499 BCBS MA
Massachusetts MEDICAID 3009017 BCBS MA
Massachusetts Other 713318 BCBS MA

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