Individual
DR. LISA MEI-INN WONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10 HAWTHORNE PL, SUITE 110, BOSTON, MA 02114-2336
(617) 724-0924
(617) 724-3413
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
55558
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004538
—
MA
01
—
719240
TUFTS HEALTH PLAN
MA
01
—
J05372
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
07/08/2007
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