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Individual
EDISON WONG
Active
Individual
EDISON WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
040751
CT
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
81293
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30555
FALLON
MA
05
—
3139875
—
MA
01
—
758575
TUFTS
MA
01
—
80911
HARV PILGRIM
MA
01
—
972848
NETWORK HEALTH
MA
01
—
J31343
BCBS
MA
01
—
P00132480
MR RR
MA
Enumeration date
11/16/2006
Last updated
04/21/2020
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