Individual
KWOK KIN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 BROOKLINE AVE, MAYER BUILDING 413, BOSTON, MA 02215-5418
(617) 632-6084
(617) 582-7839
Mailing address
450 BROOKLINE AVE, MAYER BUILDING 413, BOSTON, MA 02215-5418
(617) 632-6084
(617) 582-7839
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
157104
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0170348
MASSHEALTH MA MEDICAID
—
01
—
14721DF
HPHC DFCI
—
01
—
157104
TUFTS
—
01
—
2621393
AETNA US HEALTHCARE
—
01
—
3004733
UNITED HEALTH CARE
—
01
—
3991845
CIGNA
—
01
—
65587
FALLON COMMUNITY HLTH PLN
—
01
—
J24871
BCBS INDEMNITY BC ELECT
MA
Enumeration date
04/08/2006
Last updated
08/18/2022
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