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Individual
JENNY SUH WONG
Active
Individual
JENNY SUH WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002122
CT
363A00000X
Physician Assistant
Primary
PA08414
TX
363AS0400X
Surgical Physician Assistant
013473-1
NY
363AS0400X
Surgical Physician Assistant
PA08414
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002122
CT LICENSE
CT
05
—
323911303
—
TX
05
—
323911304
—
TX
01
—
8583NP
BCBS
TX
01
—
8765NY
BCBS
TX
Enumeration date
09/11/2008
Last updated
05/28/2026
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