Provider Demographics
NPI:1376958660
Name:DONG, CECILIA QIANWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:QIANWEN
Last Name:DONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 37TH AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6303
Mailing Address - Country:US
Mailing Address - Phone:888-212-3937
Mailing Address - Fax:
Practice Address - Street 1:774 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5316
Practice Address - Country:US
Practice Address - Phone:888-212-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300727207WX0009X, 207W00000X
CA156666207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist