Individual
DR. JENNIFER LEE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 HOWARD AVE, NEW HAVEN, CT 06519-1369
(203) 785-3091
(203) 785-6885
Mailing address
PO BOX 208063, NEW HAVEN, CT 06520-8063
(203) 785-3091
(203) 785-6885
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
254271
NY
207VM0101X
Maternal & Fetal Medicine Physician
Primary
54528
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03460964
—
NY
Enumeration date
05/06/2009
Last updated
01/30/2020
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