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Individual

DR. IRENE WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
650 UNION BLVD UNIT 16, TOTOWA, NJ 07512
(973) 938-5200
(973) 938-5191
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10295000
NJ
207Q00000X
Family Medicine Physician
260111
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03480408
NY
Enumeration date
03/01/2012
Last updated
06/04/2018
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