1467944777 NPI number — DR. STEPHANIE MARGARET WONG MD, MPH

Table of content: DUSTIN NESHEIM D.O. (NPI 1427403435)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467944777 NPI number — DR. STEPHANIE MARGARET WONG MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WONG
Provider First Name:
STEPHANIE
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

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:
1467944777
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
64 ST PAUL O
Provider Second Line Business Mailing Address:
APT 402
Provider Business Mailing Address City Name:
MONTREAL
Provider Business Mailing Address State Name:
QUEBEC
Provider Business Mailing Address Postal Code:
248
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MCGILL UNIVERSITY HEALTH CENTRE - GENERAL SURGERY
Provider Second Line Business Practice Location Address:
1650 CEDAR AVE, L9.424
Provider Business Practice Location Address City Name:
MONTREAL
Provider Business Practice Location Address State Name:
QUEBEC
Provider Business Practice Location Address Postal Code:
H3G 1A4
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
514-934-1934
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2018

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: 208600000X , with the licence number:  274174 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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