Provider Demographics
NPI:1003080581
Name:WANG, CHRISTINA HO (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:HO
Last Name:WANG
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1493 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1047
Mailing Address - Country:US
Mailing Address - Phone:617-665-2614
Mailing Address - Fax:
Practice Address - Street 1:16 BEAR HILL RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-4007
Practice Address - Country:US
Practice Address - Phone:781-944-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA919133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered