Individual
JEFFREY G WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
303 BENNER PIKE STE 1, STATE COLLEGE, PA 16801-7304
(814) 272-5660
(814) 272-5675
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
AL27458
SC
207R00000X
Internal Medicine Physician
Primary
MD455716
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030496070001
—
PA
05
—
Q32070
—
SC
Enumeration date
08/29/2006
Last updated
11/09/2017
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