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Individual
DR. SUSAN T WONG
Active
Individual
DR. SUSAN T WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
179629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00040026702
UNIVERA
NY
01
—
000916798001
BS WNY/HEALTHNOW
NY
05
—
00372225
—
NY
05
—
01575442
—
NY
01
—
050063381
RAILROAD MEDICARE
NY
01
—
2222
BLUE SHIELD GROUP
NY
01
—
5216039
AETNA
NY
01
—
G0189393590
BLUE CHOICE GROUP
NY
01
—
MDC626
PREFERRED CARE
NY
01
—
P010179629
BLUE CHOICE
NY
Enumeration date
07/18/2006
Last updated
07/09/2007
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