Provider Demographics
NPI:1578812608
Name:WONG, NATALIE (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:WONG
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 1:2500 MORRIS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5675
Mailing Address - Country:US
Mailing Address - Phone:732-906-9600
Mailing Address - Fax:
Practice Address - Street 1:329 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9229
Practice Address - Country:US
Practice Address - Phone:856-228-7246
Practice Address - Fax:833-606-0168
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10651300207L00000X, 208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine