1467437632 NPI number — DR. ALFONSO CIELO WONG JR. M.D.

Table of content: DR. ALFONSO CIELO WONG JR. M.D. (NPI 1467437632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467437632 NPI number — DR. ALFONSO CIELO WONG JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WONG
Provider First Name:
ALFONSO
Provider Middle Name:
CIELO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467437632
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HOT METAL ST
Provider Second Line Business Mailing Address:
QUANTUM ONE BUILDING, SUITE 001
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15203-2348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-647-3087
Provider Business Mailing Address Fax Number:
412-647-4486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 MARY ST
Provider Second Line Business Practice Location Address:
SUITE 2500
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15203-2054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-381-2599
Provider Business Practice Location Address Fax Number:
412-488-5256
Provider Enumeration Date:
12/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD031838L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 250072 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 83808 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1528440 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 574252 . This is a "HIGHMARK BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009514930009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2520678 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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