Provider Demographics
NPI:1306032552
Name:WONG-PEREZ, MAILINN ELEANA (MD)
Entity Type:Individual
Prefix:
First Name:MAILINN
Middle Name:ELEANA
Last Name:WONG-PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAILINN
Other - Middle Name:ELEANA
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 HOSPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4670
Mailing Address - Country:US
Mailing Address - Phone:724-285-0823
Mailing Address - Fax:724-285-0879
Practice Address - Street 1:1 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4670
Practice Address - Country:US
Practice Address - Phone:724-285-0823
Practice Address - Fax:724-285-0879
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine