Individual
JACKY KIN WAI KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
940 COMMONWEALTH AVE, BOSTON, BOSTON, MA 02215-1203
(617) 262-2020
Mailing address
1125 COMMONWEALTH AVE APT 22, ALLSTON, MA 02134-3207
(617) 818-0476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4689
MA
152WP0200X
Pediatric Optometrist
4689
MA
Other
Enumeration date
07/27/2008
Last updated
07/28/2008
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