Individual
DR. IVAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7 BACKUS AVE STE 250, DANBURY, CT 06810-7493
(203) 743-9897
(203) 743-6419
Mailing address
7 BACKUS AVE STE 250, DANBURY, CT 06810-7493
(203) 743-9897
(203) 743-6419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT002529
CT
152WC0802X
Corneal and Contact Management Optometrist
CT002529
CT
152WP0200X
Pediatric Optometrist
CT2529
CT
152WX0102X
Occupational Vision Optometrist
CT002529
CT
152WX0102X
Occupational Vision Optometrist
CT2529
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09002529CT01
ANTHEM BLUE CROSS BLUE SH
CT
01
—
7058856
AETNA
CT
Enumeration date
12/15/2006
Last updated
10/22/2007
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