Individual
DR. JOHNSON TAI WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8 HAWTHORNE PL, SUITE 104, BOSTON, MA 02114-2335
(617) 742-5730
(617) 742-6917
Mailing address
8 HAWTHORNE PL, SUITE 104, BOSTON, MA 02114-2335
(617) 742-5730
(617) 742-6917
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
53165
MA
207R00000X
Internal Medicine Physician
Primary
53165
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3009017
—
MA
01
—
713318
TUFTS HEALTH PLAN
MA
01
—
J05499
BCBS MA
MA
Enumeration date
11/04/2005
Last updated
09/11/2025
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