Provider Demographics
NPI:1467437632
Name:WONG, ALFONSO CIELO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFONSO
Middle Name:CIELO
Last Name:WONG
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE BUILDING, SUITE 001
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:2000 MARY ST
Practice Address - Street 2:SUITE 2500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2054
Practice Address - Country:US
Practice Address - Phone:412-381-2599
Practice Address - Fax:412-488-5256
Is Sole Proprietor?:No
Enumeration Date:2005-12-10
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD031838L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA250072OtherUPMC
PA83808OtherUNISON
PA1528440OtherGATEWAY
PA574252OtherHIGHMARK BCBS
PA0009514930009Medicaid
OH2520678Medicaid
PA250072OtherUPMC
PA1528440OtherGATEWAY
PAC31654Medicare UPIN