Individual
SUSAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6280
(617) 629-6275
Mailing address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6280
(617) 629-6275
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
52853
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001432
NHP
MA
01
—
0014532
BCBS
MA
05
—
3193560
—
MA
01
—
796024
TUFTS
MA
01
—
9398696-002
CIGNA
MA
01
—
E143
HPHC
MA
01
—
J03334
BCBS
MA
Enumeration date
12/20/2006
Last updated
03/08/2021
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